Stojkovic Milena, Radmanovic Branimir, Jovanovic Mirjana, Janjic Vladimir, Muric Nemanja, Ristic Dragana Ignjatovic
Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Psychiatric Clinic, University Clinical Center Kragujevac, Kragujevac, Serbia.
Front Psychiatry. 2022 May 6;13:874705. doi: 10.3389/fpsyt.2022.874705. eCollection 2022.
Risperidone is one of the most commonly used antipsychotics (AP), due to its safety and efficacy in reducing psychotic symptoms. Despite the favorable side effect profile, the therapy is accompanied by side effects due to the non-selectivity of this medicine. This review will briefly highlight the most important basic and clinical findings in this area, consider the clinical effects of AP-induced hyperprolactinemia (HPL), and suggest different approaches to the treatment.The route of application of this drug primarily affects the daily variation and the total concentration of drug levels in the blood, which consequently affects the appearance of side effects, either worsening or even reducing them. Our attention has been drawn to HPL, a frequent but neglected adverse effect observed in cases treated with Risperidone and its secondary manifestations. An increase in prolactin levels above the reference values result in impairment of other somatic functions (lactation, irregular menses, fertility) as well as a significant reduction in quality of life. It has been frequently shown that the side effects of the Risperidone are the most common cause of non-compliance with therapy, resulting in worsening of psychiatric symptoms and hospitalization. However, the mechanism of Risperidone-induced HPL is complicated and still far from fully understood. Most of the preclinical and clinical studies described in this study show that hyperprolactinemia is one of the most common if not the leading side effect of Risperidone therefore to improve the quality of life of these patients, clinicians must recognize and treat HPL associated with the use of these drugs.
利培酮是最常用的抗精神病药物之一，因其在减轻精神病症状方面的安全性和有效性。尽管副作用较小，但由于该药物的非选择性，治疗仍会伴有副作用。本综述将简要强调该领域最重要的基础和临床研究结果，考虑抗精神病药物引起的高催乳素血症（HPL）的临床影响，并提出不同的治疗方法。该药物的应用途径主要影响血液中药物水平的每日变化和总浓度，从而影响副作用的出现，可能使其恶化甚至减轻。我们的注意力集中在HPL上，这是在使用利培酮治疗的病例中观察到的一种常见但被忽视的不良反应及其继发表现。催乳素水平高于参考值会导致其他躯体功能受损（泌乳、月经不调、生育能力）以及生活质量显著下降。经常表明，利培酮的副作用是治疗依从性差的最常见原因，导致精神症状恶化和住院。然而，利培酮引起HPL的机制很复杂，仍远未完全理解。本研究中描述的大多数临床前和临床研究表明，高催乳素血症是利培酮最常见的副作用之一，如果不是主要副作用的话。因此，为了提高这些患者的生活质量，临床医生必须认识并治疗与使用这些药物相关的HPL。
