Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics.

Ana González-Pinto, Eduard Vieta, Salvador Ros, Jesús Pérez, Isabella Pachiarotti, M Teresa Mories, Jaqueline Mayoral-van Son, Fermín Mayoral-Cleries, Manuel Martín-Carrasco, Ana I Hernández, Ángel L Montejo, Clemente García-Rizo, Miguel A García-Escudero, Javier Del Pino-Montes, Juan J Cruz, Benidicto Crespo-Facorro, José L Carrasco, Miquel Bernardo, Celso Arango

Journal: Frontiers in neuroendocrinology 2018;45():25-34

PMID: 28235557

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Abstract

Hyperprolactinemia is an underappreciated/unknown adverse effects of antipsychotics. The consequences of hyperprolactinemia compromise therapeutic adherence and can be serious. We present the consensus recommendations made by a group of experts regarding the management of antipsychotic-induced hyperprolactinemia. The current consensus was developed in 3 phases: 1, review of the scientific literature; 2, subsequent round table discussion to attempt to reach a consensus among the experts; and 3, review by all of the authors of the final conclusions until reaching a complete consensus. We include recommendations on the appropriate time to act after hyperprolactinemia detection and discuss the evidence on available options: decreasing the dose of the antipsychotic drug, switching antipsychotics, adding aripiprazole, adding dopaminergic agonists, and other type of treatment. The consensus also included recommendations for some specific populations such as patients with a first psychotic episode and the pediatric-youth population, bipolar disorder, personality disorders and the elderly population.

Address: Neurosciences Area, Instituto de Biomedicina de Salamanca (IBSAL), University of Salamanca, Psychiatry Department, University Hospital of Salamanca, Salamanca, Spain. Electronic address: [email protected].; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.; Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain.; Department of Medical Oncology, Instituto de Biomedicina de Salamanca (IBSAL), University of Salamanca, University Hospital of Salamanca, Salamanca, Spain.; Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.; Psychiatry Hospitalization Unit, Hospital General y Universitario de Elche, Elche, Spain.; International Mood Disorders Research Centre, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain.; FEA Psiquiatría, Red de Salud Mental de Guipúzcoa, San Sebastián, Spain.; Institute of Psychiatric Research, Mª Josefa Recio Foundation, Bilbao, Spain; Psychiatry Clinic Padre Menni, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Pamplona, Spain.; University Regional Hospital of Malaga, Biomedical Research Institute (IBIMA), Malaga, Spain.; Sierrallana Hospital, Torrelavega, Cantabria, Spain.; Endocrinology and Nutrition Department, University Hospital of Salamanca, Salamanca, Spain.; Bipolar Disorders Program, Psychiatry Department, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.; International Institute of Applied Neurosciences, Barcelona, Spain.

DOI: 10.1016/j.yfrne.2017.02.003