Effects of aripiprazole, quetiapine and ziprasidone on plasma prolactin levels in individuals with first episode nonaffective psychosis: Analysis of a randomized open-label 1year study.

Autor: Crespo-Facorro B; University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain. Electronic address: bcfacorro@humv.es., Ortiz-Garcia de la Foz V; University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain., Suarez-Pinilla P; University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain., Valdizan EM; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Physiology and Pharmacology, and IBBTEC (UC-CSIC-SODERCAN), University of Cantabria, Spain., Pérez-Iglesias R; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Psychosis Studies Dep. PO63 5(th) floor. Main building, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London., Amado-Señaris JA; Department of Endocrinology, Marqués de Valdecilla University Hospital, Avda. Valdecilla s/n, 39008, University of Cantabria, Spain., Teresa Garcia-Unzueta M; Department of Biochemistry, Marques de Valdecilla University Hospital, Santander 39008, Spain., Labad J; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Salud Mental Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain., Correll C; The Zucker Hillside Hospital, Department of Psychiatry Research, 75-59 263rd Street, Glen Oaks, NY 11004, USA; Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY 11549, USA., Ayesa-Arriola R; University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2017 Nov; Vol. 189, pp. 134-141. Date of Electronic Publication: 2017 Feb 20.
DOI: 10.1016/j.schres.2017.01.046
Abstrakt: Rationale: Hyperprolactinemia is considered a troubling adverse effect of antipsychotics. Direct comparisons among second generation antipsychotics are scant in clinical practice. We hypothesize prolactin-sparing second-generation antipsychotics may have differential effects on prolactin levels and that they may be influenced by sex.
Objectives: To explore the differential effect of three widely used prolactin-sparing antipsychotics, aripiprazole, quetiapine and ziprasidone, on prolactin plasma levels in first episode non-affective psychosis during a 1year of treatment.
Method: From October 2005 to January 2011 a prospective, randomized, open-label study was undertaken. 141 patients who were randomly allocated to aripiprazole (N=56), quetiapine (N=36) or ziprasidone (N=49) were analyzed. The main outcome was differences in prolactin plasma levels over 1year follow-up among the three antipsychotics. Prolactin levels had a skewed distribution and therefore they were log-transformed before statistical analyses.
Results: Male patients on aripiprazole had a lower risk of suffering an increase on prolactin plasma levels (N=71; F=12.645; p<0.001). There was a gender effect with smaller changes in mean prolactin values only in males. Aripiprazole had a reduced risk of hyperprolactinemia (aripiprazole 19.6%) compared to quetiapine (44.4%) and ziprasidone (32.7%) (p=0.038); and quite similar findings were found when investigating males (p=0.040). No significant differences were found in females. The percentages of mild prolactin excess were: 14.3% on aripiprazole, 36.1% on quetiapine and 18.4% on ziprasidone (χ 2 =6.611 p=0.037).
Conclusions: Our findings provide additional evidence of differential effects of three sparing-prolactin antipsychotics on prolactin release and may help clinicians to decide among therapeutic options.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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