Al Harthi Mohamed S, Al Ghafri Thamra S, Al Wasify Loai, Al Akhzami Salma, AlHarthi Ahmed, Al Harthi Saud, Al Sibani Nasser
College of Medicine, Sultan Qaboos University, Muscat, OMN.
Primary Care, Oman Ministry of Health, Muscat, OMN.
Cureus. 2022 Jan 23;14(1):e21532. doi: 10.7759/cureus.21532. eCollection 2022 Jan.
Hyperprolactinemia is a common side effect associated with the use of anti-psychotic medications. This study aimed at exploring the rate of hyperprolactinemia induced by anti-psychotic drugs in adult patients admitted to Sultan Qaboos University Hospital (SQUH) and Al Masarra hospital (AMH). Additionally, factors associated with higher prolactin levels in anti-psychotic patients were explored.
Bespoke XL sheets on age, gender, region (place of stay), BMI, diagnosis, type of drugs, dose, symptoms, and prolactin levels were recorded from the existing health information system. All adult patients who were on anti-psychotic medication between January 2016 and June 2019 were included. Patients diagnosed with pre-existing endocrine conditions, pregnant females, and those with high prolactin levels at baseline were excluded.
A total of 1103 cases were included in this study of which 34.1% were from the SQUH vs 65.9% from AMH. The mean (SD) age of the study population was 35.6 (12.1), 56.7% were females and 58.7% cases were from Muscat. The common diagnoses were schizophrenia (59.3%) and bipolar affective disorder (14.7%). High prolactin levels existed in 68.3% of the cases from which 59.6% were treated with atypical anti-psychotic drugs. The proportion of cases with high prolactin levels in AMH was significantly different (higher) compared to cases in SQUH (76.9% vs 51.6%, P<0.001). The most common symptoms were painful breasts (55.2%), galactorrhoea (10.5%), amenorrhea (14.3%) and irregular periods (20.0%). Type of drugs used [haloperidol (typical) vs risperidone (atypical) anti-psychotics (P<0.001)], older vs younger age (P=0.03), and presence vs absence of symptoms (P<0.001) were predictors for the high prolactin levels.
Similar to evidence from the west, results from this study showed a high rate of hyperprolactinemia in adults treated with anti-psychotics. More work is required to standardize anti-psychotic management and monitoring guidelines for psychotic patients across all psychiatric hospitals in Oman.
高催乳素血症是使用抗精神病药物常见的副作用。本研究旨在探究在苏丹卡布斯大学医院（SQUH）和马斯拉医院（AMH）住院的成年患者中，抗精神病药物所致高催乳素血症的发生率。此外，还探究了抗精神病患者中催乳素水平升高的相关因素。
从现有的健康信息系统中记录有关年龄、性别、地区（居住地点）、体重指数、诊断、药物类型、剂量、症状和催乳素水平的定制XL表格。纳入2016年1月至2019年6月期间所有服用抗精神病药物的成年患者。排除已诊断患有内分泌疾病的患者、怀孕女性以及基线催乳素水平高的患者。
本研究共纳入1103例病例，其中34.1%来自SQUH，65.9%来自AMH。研究人群的平均（标准差）年龄为35.6（12.1）岁，56.7%为女性，58.7%的病例来自马斯喀特。常见诊断为精神分裂症（59.3%）和双相情感障碍（14.7%）。68.3%的病例存在高催乳素水平，其中59.6%接受非典型抗精神病药物治疗。AMH中高催乳素水平病例的比例与SQUH中的病例相比有显著差异（更高）（76.9%对51.6%，P<0.001）。最常见的症状是乳房疼痛（55.2%）、溢乳（10.5%）、闭经（14.3%）和月经不规律（20.0%）。所用药物类型[氟哌啶醇（典型）与利培酮（非典型）抗精神病药物（P<0.001）]、年龄较大与年龄较小（P=0.03）以及有无症状（P<0.001）是高催乳素水平的预测因素。
与西方的证据相似，本研究结果显示使用抗精神病药物治疗的成年人中高催乳素血症的发生率较高。阿曼所有精神病医院需要开展更多工作来规范精神病患者的抗精神病管理和监测指南。
