Prolactin Level Changes according to Atypical Antipsychotics Use: A Study Based on Clinical Data Warehouse
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: Antipsychotic drugs are known as the major cause of non-neoplastic hyperprolactinemia. This study aimed to investigate the levels of serum prolactin depending on the use of antipsychotic drugs in patients through the Clinical Data Warehouse (CDW). Methods: We conducted a cohort search in the CDW application and got 260 patients’ medical records diagnosed with schizophrenia, schizotypal and delusional disorders, manic episodes, and bipolar affective disorders who were taking one of risperidone, blonanserin, amisulpride, and olanzapine. After that, we reviewed the medical data and used the ANCOVA analysis and the post hoc test to compare serum prolactin levels among four antipsychotic drug groups. Results: Among the 117 subjects included in the analysis, the mean serum prolactin level was 64.6 ± 54.6 ng/ml. Serum prolactin levels were significantly higher in subjects taking risperidone or amisulpride compared to blonanserin and olanzapine. The female subjects who took blonanserin, olanzapine, and risperidone had significantly higher prolactin levels, but there was no difference in serum prolactin levels between sex in the subjects who took amisulpride. Conclusion: This study suggests the need for regular monitoring of serum prolactin levels in patients who are taking antipsychotics, especially in female patients. And we showed that there is a possibility to conduct more effective and simpler big data research using the CDW. Further studies on the subjects with controlled confounding variables and larger sample groups are needed.
Abstract
Objective: Antipsychotic drugs are known as the major cause of non-neoplastic hyperprolactinemia. This study aimed to investigate the levels of serum prolactin depending on the use of antipsychotic drugs in patients through the Clinical Data Warehouse (CDW). Methods: We conducted a cohort search in the CDW application and got 260 patients’ medical records diagnosed with schizophrenia, schizotypal and delusional disorders, manic episodes, and bipolar affective disorders who were taking one of risperidone, blonanserin, amisulpride, and olanzapine. After that, we reviewed the medical data and used the ANCOVA analysis and the post hoc test to compare serum prolactin levels among four antipsychotic drug groups. Results: Among the 117 subjects included in the analysis, the mean serum prolactin level was 64.6 ± 54.6 ng/ml. Serum prolactin levels were significantly higher in subjects taking risperidone or amisulpride compared to blonanserin and olanzapine. The female subjects who took blonanserin, olanzapine, and risperidone had significantly higher prolactin levels, but there was no difference in serum prolactin levels between sex in the subjects who took amisulpride. Conclusion: This study suggests the need for regular monitoring of serum prolactin levels in patients who are taking antipsychotics, especially in female patients. And we showed that there is a possibility to conduct more effective and simpler big data research using the CDW. Further studies on the subjects with controlled confounding variables and larger sample groups are needed.
참고문헌 (34)
- Matei VP, "Prolactin level in patients with first episode schizophrenia treated for one year with atypical antipsychotics", Acta Endocrinol(Buchar), 14, pp.483~490 (2018)
- Halperin Rabinovich I, "Clinical guidelines for diagnosis and treatment of prolactinoma and hyperprolactinemia", Endocrinol Nutr, 60, pp.308~319 (2013)
- Byerly M, "Clinical implications of antipsychotic-induced hyperprolactinemia in patients with schizophrenia spectrum or bipolar spectrum disorders : Recent developments and current perspectives", J Clin Psychopharmacol, 27, pp.639~661 (2007)
- Inder WJ, "Antipsychotic-induced hyperprolactinaemia", Aust N Z J Psychiatry, 45, pp.830~837 (2011)
- Poo SX, "Atypical antipsychotics for schizophrenia and", or bipolar disorder in pregnancy : Current recommendations and updates in the NICE guidelines, 2015, pp.27(Suppl 1), S255~S260
- Bushe C, "A review of the association between antipsychotic use and hyperprolactinaemia", J Psychopharmacol, 22(2 Suppl), pp.46~55 (2008)
- Chwieduk CM, "Paliperidone extended release : A review of its use in the management of schizophrenia", Drugs, 70, pp.1295~1317 (2010)
- Madhusoodanan S, "Hyperprolactinemia associated with psychotropics--a review", Hum Psychopharmacol, 25, pp.281~297 (2010)
- Stevens JR, "Elevated prolactin levels in male youths treated with risperidone and quetiapine", J Child Adolesc Psychopharmacol, 15, pp.893~900 (2005)
- Bushe C, "Prevalence of hyperprolactinaemia in a naturalistic cohort of schizophrenia and bipolar outpatients during treatment with typical and atypical antipsychotics", J Psychopharmacol, 21, pp.768~773 (2007)
- Montgomery J, "Prevalence of hyperprolactinemia in schizophrenia : association with typical and atypical antipsychotic treatment", J Clin Psychiatry, 65, pp.1491~1498 (2004)
- Turrone P, "Elevation of prolactin levels by atypical antipsychotics", Am J Psychiatry, 159, pp.133~135 (2002)
- Yu W, "Model-based analysis of therapeutic efficacy of blonanserin and risperidone in schizophrenia patients and effects on prolactin : A randomized double-blind study", Hum Psychopharmacol, 35, pp.e2717~ (2020)
- Kawabe K, "Blonanserin, a novel antipsychotic, is suitable for treating schizophrenia associated with hyperprolactinemia : a case series", Clin Neuropharmacol, 36, pp.239~241 (2013)
- Kelly DL, "Treating symptomatic hyperprolactinemia in women with schizophrenia : Presentation of the ongoing DAAMSEL clinical trial(Dopamine partial Agonist, Aripiprazole, for the Management of Symptomatic ELevated prolactin)", BMC Psychiatry, 13, pp.214~ (2013)
- Bushe CJ, "A review of hyperprolactinaemia and severe mental illness : are there implications for clinical biochemistry?", Ann Clin Biochem, 47, pp.292~300 (2010)
- 이가희, "항정신병약물을 복용중인 정신분열병 환자에서 고프로락틴혈증과 무월경 유병률 및 성기능 장애와 관련성", 신경정신의학, 48(6), pp.422~428 (2009), 대한신경정신의학회
- Korean Psychosmatic Society, "Treatment guidelines for antipsychotics drug-induced hyperprolactinemia", Korean Psychosmatic Society, ~ (2022)
- 강은영, "신생병원의 5년 유방암 치료 경험: 임상 데이터 웨어하우스를 이용한 분석", Journal of Breast Cancer, 13(1), pp.96~103 (2010), 한국유방암학회
- Serri O, "Diagnosis and management of hyperprolactinemia", CMAJ, 169, pp.575~581 (2003)
- Serri O, "The influences of hyperprolactinemia and obesity on cardiovascular risk markers: Effects of cabergoline therapy", Clin Endocrinol(Oxf), 64, pp.366~370 (2006)
- Inada T, "Psychotropic dose equivalence in Japan", Psychiatry Clin Neurosci, 69, pp.440~447 (2015)
- Svestka J, "Differences in the effect of second-generation antipsychotics on prolactinaemia : six weeks open-label trial in female in-patients", Neuro Endocrinol Lett, 28, pp.881~888 (2007)
- Park YM, "Prolactin and macroprolactin levels in psychiatric patients receiving atypical antipsychotics : A preliminary study", Psychiatry Res, 239, pp.184~189 (2016)
- Howard L, "Risk of hip fracture in patients with a history of schizophrenia", Br J Psychiatry, 190, pp.129~134 (2007)
- Wang PS, "Dopamine antagonists and the development of breast cancer", Arch Gen Psychiatry, 59, pp.1147~1154 (2002)
- Pérez-Iglesias R, "Long-term effect of haloperidol, olanzapine, and risperidone on plasma prolactin levels in patients with first-episode psychosis", J Clin Psychopharmacol, 32, pp.804~808 (2012)
- Kopecek M, "Hyperprolactinemia after low dose of amisulpride", Neuro Endocrinol Lett, 25, pp.419~422 (2004)
- Besnard I, "Antipsychotic-drug-induced hyperprolactinemia: physiopathology, clinical features and guidance", Encephale, 40, pp.86~94 (2014)
- Tenjin T, "Profile of blonanserin for the treatment of schizophrenia", Neuropsychiatr Dis Treat, 9, pp.587~594 (2013)
- Crawford AM, "The acute and long-term effect of olanzapine compared with placebo and haloperidol on serum prolactin concentrations", Schizophr Res, 26, pp.41~54 (1997)
- "Menopause" (2021)[URL]
- Takahashi S, "One-year follow-up study of psychotic patients treated with blonanserin : a case series", Asia Pac Psychiatry, 5, pp.164~167 (2013)
- Chen YL, "Prolactin levels in olanzapine treatment correlate with positive symptoms of schizophrenia : Results from an open-label, flexible-dose study", Prim Care Companion J Clin Psychiatry, 11, pp.16~20 (2009)
