Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Bangkok, Thailand ; Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, Bangkok, Thailand.
Neuropsychiatr Dis Treat. 2015 Jan 22;11:191-6. doi: 10.2147/NDT.S76276. eCollection 2015.
Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD) during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females) aged 3-19 years with ASD received risperidone treatment (0.10-6.00 mg/day) for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records - age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern - were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90%) subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.30-29.20) of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.65-22.30) and low (11.70, IQR 7.51-16.50) doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with risperidone. This study suggests that risperidone treatment causes prolactin elevations and the effects of risperidone on prolactin are probably dose-related in pediatric patients.
高泌乳素血症是自闭症谱系障碍（ASD）儿童在接受利培酮药物治疗时常见的不良反应。本研究的主要目的是探讨影响利培酮治疗泰国 ASD 儿童泌乳素反应的重要临床因素。共有 147 名 3-19 岁的 ASD 儿童和青少年（127 名男性和 20 名女性）接受利培酮治疗（0.10-6.00mg/天），最长达 158 周。通过化学发光免疫分析法测量泌乳素水平。从病历中收集患者的临床数据 - 年龄、体重、身高、体重指数、利培酮剂量、治疗持续时间和用药模式 - 记录下来。147 名患者中有 66 名（44.90%）出现高泌乳素血症。高剂量利培酮（24.00，四分位间距 [IQR] 14.30-29.20）的中位泌乳素水平明显高于推荐剂量（16.20，IQR 10.65-22.30）和低剂量（11.70，IQR 7.51-16.50）。利培酮治疗持续时间与泌乳素水平之间没有关系。剂量依赖性被确定为与接受利培酮治疗的泰国 ASD 儿童和青少年高泌乳素血症相关的主要因素。本研究表明，利培酮治疗会导致泌乳素升高，利培酮对泌乳素的影响可能与剂量有关。
