Association and Factors of Risperidone Induced Hyperprolactinemia
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Abstract
Objective: The primary objective was to study the association between serum prolactin levels and risperidone as well as other factors and to study the association between serum prolactin levels and the clinical symptoms of hyperprolactinemia. The secondary objective was to study the outcomes of prolactin level management in patients receiving risperidone.
Methods: This retrospective analytical study collected data from the electronic medical records of patients receiving risperidone and measurement of prolactin level at Suanprung Psychiatric Hospital, Suansaranrom Hospital, and Prasrimahabhodi Psychiatric Hospital between January 1, 2021, and July 31, 2023. Data were analyzed using descriptive statistics, linear regression, and paired t-test.
Results: A total of 190 patients were included. Most were female (95.3%). The mean risperidone dosage was 2.92 ± 1.92 mg/day, and the mean serum prolactin level was 81.20 ± 57.48 ng/mL. Multivariable linear regression analysis showed that risperidone dosage was positively associated with serum prolactin levels with statistical significance (β = 9.03, 95% CI: 4.85 - 13.21, P < 0.001), as well as educational level at secondary to sub-bachelor education level (P = 0.023). In contrast, the body mass index was negatively associated with serum prolactin levels (P = 0.023). The most common clinical manifestations were menstrual irregularity (74.5%), galactorrhea (50.4%), and gynecomastia (42.3%). However, there was no statistically significant association between the severity of hyperprolactinemia and the clinical symptoms. Management strategies including drug discontinuation, medication switching, and dose reduction of risperidone significantly decreased serum prolactin levels (P < 0.001).
Conclusion: This study demonstrated that risperidone dosage was significantly associated with serum prolactin levels. However, no significant association was observed between prolactin levels and clinical manifestations of risperidone-induced hyperprolactinemia. Discontinuation, switching, or dose reduction of risperidone significantly decreased prolactin levels. These findings may serve as preliminary evidence to inform screening strategies and optimize management of risperidone-induced hyperprolactinemia in routine clinical practice.
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