Huang Ying-Lin, Peng Miao, Zhu Gang
Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Department of Psychiatry, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Med Hypotheses. 2020 May;138:109607. doi: 10.1016/j.mehy.2020.109607. Epub 2020 Jan 30.
Hyperprolactinemia is a common but neglected adverse effect of antipsychotic agents. Current treatments for antipsychotic-induced hyperprolactinemia exert their action mainly through the mechanism of enhancing the inhibitory effect of dopamine on prolactin secretion; however, patients have to endure the risk of psychotic relapse or exacerbation. Topiramate, a new anticonvulsant, is widely used in the treatment of numerous psychiatric conditions. It can antagonize α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) and kainate (KA) glutamate receptors and enhance the inhibitory activity of γ-amino butyric acid (GABA). Inhibition of AMPA and KA receptors and increased GABA activity has been proved to have an inhibitory effect on prolactin release. Thus, topiramate may be an effective agent in the treatment of antipsychotic-induced hyperprolactinemia.
高泌乳素血症是抗精神病药物常见但被忽视的不良反应。目前抗精神病药物所致高泌乳素血症的治疗主要通过增强多巴胺对泌乳素分泌的抑制作用机制发挥作用；然而，患者不得不承受精神病复发或病情加重的风险。托吡酯是一种新型抗惊厥药，广泛用于治疗多种精神疾病。它可拮抗α-氨基-3-羟基-5-甲基异恶唑-4-丙酸（AMPA）和海人藻酸（KA）谷氨酸受体，并增强γ-氨基丁酸（GABA）的抑制活性。已证实抑制AMPA和KA受体以及增加GABA活性对泌乳素释放有抑制作用。因此，托吡酯可能是治疗抗精神病药物所致高泌乳素血症的有效药物。
