Baptista T, Alastre T, Contreras Q, Martinez J L, Araujo de Baptista E, Páez X, Hernández L
Laboratory of Behavioral Physiology, Medical School, Universidad de los Andes, Mérida, Venezuela.
Pharmacopsychiatry. 1997 Nov;30(6):250-5. doi: 10.1055/s-2007-979502.
Metabolic and endocrine abnormalities secondary to hyperprolactinemia, particularly hypogonadism, may be involved in the excessive body weight gain observed during treatment with antipsychotic drugs. The present study was conducted in healthy men in order to detect an endocrine imbalance secondary to antipsychotic drug administration, which, if sustained in the long term, might be involved in the development of obesity. Sulpiride (200 mg daily for 30 days) or placebo was nonblindly administered, and body weight gain was correlated with the serum levels of prolactin, luteinizing hormone, follicle-stimulating hormone, estradiol, free testosterone, thyrotropic hormone, free tetraiodothyroxine, cortisol, dehydroepiandrosterone sulphate (DHEA-S), and the ratios estradiol/testosterone and testosterone/DHEA-S; the blood lipids were also assessed. Body weight gain and the serum levels of prolactin were significantly increased by sulpiride; in addition, a significant positive correlation was observed between prolactin levels and body weight gain. Other endocrine parameters were not significantly affected by the drug. These short-term results show that in healthy men, body weight can be increased by antipsychotic drug administration; this effect may be related to hyperprolactinemia alone, since other endocrine parameters were normal at the time of treatment. A more prolonged treatment with antipsychotic agents might be required to observe the alterations in gonadal and adrenal steroids often detected in subjects with primary obesity.
高催乳素血症继发的代谢和内分泌异常，尤其是性腺功能减退，可能与抗精神病药物治疗期间观察到的体重过度增加有关。本研究在健康男性中进行，以检测抗精神病药物给药继发的内分泌失衡，这种失衡如果长期持续，可能与肥胖的发生有关。非盲法给予舒必利（每日200毫克，共30天）或安慰剂，并将体重增加与催乳素、黄体生成素、卵泡刺激素、雌二醇、游离睾酮、促甲状腺激素、游离甲状腺素、皮质醇、硫酸脱氢表雄酮（DHEA-S）的血清水平以及雌二醇/睾酮和睾酮/DHEA-S的比值相关联；还评估了血脂。舒必利使体重增加和催乳素血清水平显著升高；此外，观察到催乳素水平与体重增加之间存在显著正相关。其他内分泌参数未受到该药物的显著影响。这些短期结果表明，在健康男性中，抗精神病药物给药可导致体重增加；这种效应可能仅与高催乳素血症有关，因为治疗时其他内分泌参数正常。可能需要更长时间的抗精神病药物治疗，才能观察到原发性肥胖患者中经常检测到的性腺和肾上腺类固醇的变化。
