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Psychiatr Prax 2003; 30: 97-101
DOI: 10.1055/s-2003-39764
Pharmakotherapie
© Georg Thieme Verlag Stuttgart · New York

Prolaktinplasmaspiegel und Häufigkeit der endokrinologischen Begleitwirkungen unter Therapie mit den atypischen Neuroleptika

Prolactin Levels and Symptoms of Hyperprolactinemia in Patients Treated with Amisulpride, Risperidone, Olanzapine and QuetiapineMirijam  Fric1 , Gerd  Laux1
  • 1Bezirksklinikum Gabersee, Fachkrankenhaus für Psychiatrie, Psychotherapie und Neurologie, Wasserburg a. Inn
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Publication History

Publication Date:
04 June 2003 (online)

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Zusammenfassung

Der Dopamin-Rezeptor-Blockade-bedingte Prolaktinanstieg unter Neuroleptika kann klinisch akut Gynäkomastie, Galaktorrhö, Amenorrhö, Libidominderung und Orgasmusstörungen sowie chronisch Osteoporose und kardiovaskuläre Erkrankungen bewirken. Ziel der vorliegenden Untersuchung war die Überprüfung des Zusammenhangs zwischen den Prolaktinplasmakonzentrationen und der Häufigkeit klinisch relevanter endokrinologischer Symptome unter Behandlung mit den atypischen Neuroleptika Amisulprid, Risperidon, Olanzapin und Quetiapin. Amisulprid und - in geringerem Ausmaß - Risperidon führten zu deutlicher, meist anhaltender Erhöhung der Prolaktinplasmaspiegel. Unter Quetiapin und Olanzapin wurden passagere Erhöhungen festgestellt. Keine Zusammenhänge konnten zwischen der Dosis der Medikation und den Prolaktinplasmaspiegeln gefunden werden. Insgesamt zeigten nur 22 % aller behandelten Patienten klinische Zeichen einer Hyperprolaktinämie. Bei den mit Amisulprid behandelten Frauen wurden diese signifikant häufiger festgestellt.

Abstract

Elevations in prolactin plasma concentration occur with antipsychotics due to their dopamine D2 receptor antagonism. Hyperprolactinemia may be associated with both acute (galactorrhea, amenorrhea, decreased libido etc.) and chronic (predisposition to osteoporosis and cardiovascular disease) treatment emergent effects in both men and women associated with apparently impaired compliance. The aim of our study was to investigate these supposed effects regarding clinically relevant endocrinologic symptoms under routine treatment conditions with newer, atypical antipsychotics. Our findings confirm that amisulpride frequently leads to a remarkable elevation of prolactin plasma concentration, same - in minor degree - for risperidone. Under treatment with quetiapine and olanzapine just temporary elevated prolactin levels were registered. However, no correlation between prolactin levels and dosage could be found. In females treated with amisulpride acute hormonal side effects were seen in a clinically relevant manner. Features of illness itself, stress factors, concomitant medication or other patient's conditions are supposed to be relevant factors for acute endocrine symptomatology.

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Dr. med. Mirijam Fric

Bezirksklinikum Gabersee

83512 Wasserburg a. Inn

Email: M.Fric.BZK-Gabersee@t-online.de

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