Hyperprolactinemia in Psychiatric Patients

Abstract

Hyperprolactinemia is a side effect caused by Antipsychotic, especially Typical Antipsychotic and Atypical Antipsychotic (Risperidone, Paliperidone and Amisulpride). Those are categorized to Prolactin Raising Antipsychotic (PRA). The prevalence of Hyperprolactinemia in PRA is 47.6-65.6% and vary with gender and age. The definition of Hyperprolactinemia in man is prolactin level >20 ng/ml and in a woman is prolactin level > 25 ng/ml Hyperprolactinemia can be associated with health issues in the short term and long term. In the short term, women and men are developed loss of libido galactorrhea gynecomastia and infertile while in women oligo menorrhea and amenorrhea are developed. These side effects also contributed patients to non-compliance and hence relapse. In long term side effects are osteoporosis, breast cancer which are the silence risks for patients to develop fracture or metastasis of cancer. The consequence make patient to be a disability and high health care expenditure. Management of antipsychotic-induced hyperprolactinemia should be tailored to the individual. First reduced the dose of antipsychotic or changed antipsychotic. The other options should include to prescribe Dopamine agonist or add on Aripiprazole or Estrogen, Testosterone. But all options should consider about psychiatric symptoms and circumstance of the individual patient.