Alshabeeb Zahra Hussain, Alsuwayni Bashayr, Alshargi Omar, Abdelazeem Ahmed H
Psychiatric Clinical Pharmacy Services; Erada Complex for Mental Health, Dammam, Saudi Arabia.
Ambulatory Care Clinical Pharmacy Services, King Saud Medical City, Riyadh, Saudi Arabia.
Curr Drug Saf. 2025;20(2):214-223. doi: 10.2174/0115748863280407240305070905.
Hyperprolactinemia is a commonly underestimated adverse effect of antipsychotic medications. There are still no consensus guidelines for the optimal monitoring and treatment strategies.
The aim of the study was to assess the monitoring and treatment practices of antipsychotic- induced hyperprolactinemia, in addition to the prevalence and risk factors associated with it.
A retrospective cohort observational study was conducted among patients attending the psychiatric clinics at an academic tertiary hospital in Riyadh, Saudi Arabia, from May 2020 until May 2021, by reviewing each patient's medical record for up to five years.
Among the 662 patients, 35 patients (5.3%) and 242 patients (36.6%) had their serum prolactin levels monitored (at baseline and at follow-up, respectively). The prevalence of hyperprolactinemia was observed in 212 patients (32%). Only 76 patients (36%) were symptomatic. Female gender, younger age, and bipolar disorder had a significantly higher risk of developing hyperprolactinemia. 60% of the confirmed cases received treatment, of which 76 (60%) were adherent to treatment guidelines. The most common treatment strategies implemented were dose reduction (42.5%) and aripiprazole augmentation (29.1%).
It is imperative to conduct a baseline check of prolactin levels before commencing any antipsychotic therapy. Similarly, routine prolactin level monitoring is recommended regardless of symptoms in patients treated with antipsychotics with a possible prolactin-raising effect. Adherence to evidence-based treatment guidelines can improve patient quality of life and therapeutic compliance.
高催乳素血症是抗精神病药物一种常被低估的不良反应。对于最佳监测和治疗策略，目前仍未达成共识指南。
本研究旨在评估抗精神病药物所致高催乳素血症的监测和治疗实践，以及与之相关的患病率和危险因素。
2020年5月至2021年5月，在沙特阿拉伯利雅得一家学术型三级医院的精神科门诊患者中进行了一项回顾性队列观察研究，通过查阅每位患者长达五年的病历。
在662例患者中，分别有35例（5.3%）和242例（36.6%）进行了血清催乳素水平监测（分别在基线和随访时）。观察到212例患者（32%）患有高催乳素血症。只有76例患者（36%）有症状。女性、较年轻年龄以及双相情感障碍患者发生高催乳素血症的风险显著更高。60%的确诊病例接受了治疗，其中76例（60%）遵循了治疗指南。实施的最常见治疗策略是减量（42.5%）和阿立哌唑增效（29.1%）。
在开始任何抗精神病治疗之前，必须对催乳素水平进行基线检查。同样，对于接受可能具有升高催乳素作用的抗精神病药物治疗的患者，无论有无症状，建议进行常规催乳素水平监测。遵循循证治疗指南可改善患者生活质量和治疗依从性。
