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Author: Admin | 2025-04-28
Are published in the Physician's Desk Reference (PDR); a useful reference source since it reports incidence rates for most adverse effects, including EPS, weight gain, and somnolence. The PDR states that "olanzapine elevates prolactin levels, and a modest elevation persists during chronic administration." The following adverse effects are listed as "frequent": decreased libido, amenorrhoea, metrorrhagia (uterine bleeding at irregular intervals), vaginitis. For Seroquel (quetiapine), the PDR states, "an elevation of prolactin levels was not demonstrated in clinical trials", and no adverse effects relating to sexual dysfunction are listed as "frequent". The PDR states that "Risperdal (risperidone) elevates prolactin levels and the elevation persists during chronic administration." The following adverse effects are listed as "frequent": diminished sexual desire, menorrhagia, orgastic dysfunction, and dry vagina.Management of HyperprolactinaemiaBefore initiating antipsychotic treatment, a careful examination of the patient is necessary. In routine situations, clinicians should examine patients for evidence of sexual adverse events, including menorrhagia, amenorrhoea, galactorrhoea and erectile/ejaculatory dysfunction. If evidence of any such effects are found, then the patient's prolactin level should be measured. This is an important prerequisite to differentiate between adverse effects due to the current medication, those remaining from the previous medication or symptoms of the illness. Furthermore, such checks should be repeated at regular intervals.The current recommendation is that a rise in prolactin concentrations should not be of concern unless complications develop, and until such time no change in treatment is required. Increased prolactin may be due to the formation of macroprolactin, which does not have serious consequences for the patient. If there are doubts that hyperprolactinemia is related to antipsychotic treatment, other possible causes of the hyperprolactinemia have to be excluded; these include pregnancy, nursing, stress, tumors and other drug therapies.When treating antipsychotic-induced hyperprolactinemia, decisions should be made on an individual basis after a full and frank
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