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Menstrual Irregularities and Sex Hormones in Female Patients Treated with Conventional Antipsychotics for more than 5 Years

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Objective : This study was designed to observe the menstrual patterns of female chronic psychiatric patients treated with antipsychotic drugs and to assess prolactin and estradiol levels to determine the relationship among prolactin, menstrual irregularities and sex hormones. Methods:Sixty female inpatients who had been treated with antipsychotics for more than 5 years participated in this study. The first day of each menstrual cycle during a 6-month period was recorded after menstruation was confirmed by nursing staff. Blood samples were taken at an early follicular phase for menstruating patients and randomly for amenorrheic patients to assess prolactin and estradiol levels. Results:Of the 60 subjects, 12 experienced regular and 23 experienced irregular menstruation. Twenty-five patients were amenorrheic. Hyperprolactinemia was found in 80% of all subjects. The amenorrheic group showed higher prolactin levels, and these levels were correlated with dosage of antipsychotics. Estradiol was lower than 10 pg/ml (undetectable) in 77% of the patients but was exceptionally high in a few participants. Conclusion: About 80% of participants experienced menstrual disturbance, hyperprolactinemia, or hypoestrogenism. These findings suggest that hypothalamic-pituitary-ovarian axis dysfunction was very common in chronic psychiatric patients receiving long-term treatment with antipsychotic medication and should be considered in clinical practice.

Abstract

Objective : This study was designed to observe the menstrual patterns of female chronic psychiatric patients treated with antipsychotic drugs and to assess prolactin and estradiol levels to determine the relationship among prolactin, menstrual irregularities and sex hormones. Methods:Sixty female inpatients who had been treated with antipsychotics for more than 5 years participated in this study. The first day of each menstrual cycle during a 6-month period was recorded after menstruation was confirmed by nursing staff. Blood samples were taken at an early follicular phase for menstruating patients and randomly for amenorrheic patients to assess prolactin and estradiol levels. Results:Of the 60 subjects, 12 experienced regular and 23 experienced irregular menstruation. Twenty-five patients were amenorrheic. Hyperprolactinemia was found in 80% of all subjects. The amenorrheic group showed higher prolactin levels, and these levels were correlated with dosage of antipsychotics. Estradiol was lower than 10 pg/ml (undetectable) in 77% of the patients but was exceptionally high in a few participants. Conclusion: About 80% of participants experienced menstrual disturbance, hyperprolactinemia, or hypoestrogenism. These findings suggest that hypothalamic-pituitary-ovarian axis dysfunction was very common in chronic psychiatric patients receiving long-term treatment with antipsychotic medication and should be considered in clinical practice.

참고문헌 (23)

  1. Clemens JA, "Antipsychotic drugs stimulate prolactin release", Psychopharmacologia, 40, pp.123~127 (1974)
  2. Mancini AM, "Effect of sulpiride on serum prolactin levels in humans", J Clin Endocrinol Metab, 42, pp.181~184 (1976)
  3. Meltzer HY, "The effect of neuroleptics on serum prolactin in schizophrenic patients", Arch Gen Psychiatry, 33, pp.279~286 (1976)
  4. Rubin RT, "Prolactin and schizophrenia. In: Psychopharmacology: The Third Generation of Progress", pp.803~808 (1987), Raven Press
  5. Petty RG, "Prolactin and antipsychotic medications: mechanism of action", Schizophr Res, 35, pp.67~73 (1999)
  6. Vance ML, "Neuroendocrinology: New directions in the treatment of hyperprolactinemia", Endocrinologist, 7, pp.153~159 (1997)
  7. Corenblum B, "Disorders of prolactin secretion. In: Textbook of Gynecology", pp.447~467 (1993), W.B. Saunders
  8. Smith S, "Effects of antipsychotics on sexual and endocrine function in women: implications for clinical practice", J Clin Psychopharmacol, 23(3), pp.27~32 (2003)
  9. Polishuk WZ, "Effects of chlorpromazine on pituitary function", J Clin Endocrinol Metab, 16, pp.292~293 (1956)
  10. Ghadirian AM, "Sexual dysfunction and plasma prolactin levels in neuroleptic-treated schizophrenic outpatients", J Nerv Ment Dis, 170, pp.463~467 (1982)
  11. Prentice DS, "Role of neuroleptic drugs and organic mechanisms in the aetiology of menstrual irregularities in schizophrenic women", Schizophr Res, 6, pp.114~ (1992)
  12. Sullivan G, "Sexual side effects of antipsychotic medication: evaluation and interventions", Hosp Community Psychiatry, 41, pp.1238~1241 (1990)
  13. Smith S, "The effects of antipsychotic-induced hyperprolactinaemia on the hypothalamic- pituitary-gonadal axis", J Clin Psychopharmacol, 22, pp.109~114 (2002)
  14. Magharious W, "Relationship of gender and menstrual status to symptoms and medication side effects in patients with schizophrenia", Psychiatry Res, 77, pp.159~166 (1998)
  15. Canuso CM, "Antipsychotic medication, prolactin elevation, and ovarian function in women with schizophrenia and schizoaffective disorder", Psychiatry Res, 111, pp.11~20 (2002)
  16. Meaney AM, "Effects of long-term prolactin-raising antipsychotic medication on bone mineral density in patients with schizophrenia", Br J Psychiatry, 184, pp.503~508 (2004)
  17. Berek JS, "Berek & Novak's gynecology. 14th ed", pp.461~1036 (2006), Lippincott Williams & Wilkins
  18. Sadock BJ, "Kaplan & Sadock's synopsis of psychiatry. 10th ed", pp.1047~ (2007), Lippincott Wiliams & Wilkins
  19. Gerlach J, "Sulpiride and haloperidol in schizophrenia: a doubleblind cross-over study of therapeutic effect, side effects and plasma concentrations", Br J Psychiatry, 147, pp.283~288 (1985)
  20. Riecher-Rö ssler A, "Can estradiol modulate schizophrenic symptomatology?", Schizophr Bull, 20, pp.203~214 (1994)
  21. Green AI, "Prolactin and neuroleptic drugs", Neurol Clin, 6, pp.213~223 (1988)
  22. McKinlay SM, "The normal menopause transition", Maturitas, 14, pp.103~115 (1992)
  23. Marken PA, "Management of psychotropic- induced hyperprolactinemia", Clin Pharm, 11, pp.851~856 (1992)

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