Occurrence of macroprolactinemia in schizophrenia patients treated with risperidone or amisulpride

Asia Pac Psychiatry. 2022 Mar;14(1):e12469. doi: 10.1111/appy.12469. Epub 2021 Mar 22.

Abstract

Objective: To investigate macroprolactinemia caused by antipsychotics and its clinical significance.

Methods: A total of 133 patients with schizophrenia were selected, all of whom were treated with either risperidone or amisulpride alone. The levels of total prolactin (T-PRL) and macroprolactin (MPRL) were measured before treatment as well as the second, fourth, and sixth weeks of treatment.

Results: After 2 weeks of treatment, 75.09% (100/133) of the patients met the diagnostic criteria for hyperprolactinemia, the incidence of macroprolactinemia was 43% (43/100), and MPRL levels were positively correlated T-PRL levels.

Conclusion: Risperidone and amisulpride caused hyperprolactinemia and macroprolactinemia; thus, detection of MPRL in the clinical setting should be performed as this phenomenon appears early in treatment (the second week) and continues, that can avoid unnecessary examination and treatment for asymptomatic patients with macroprolactinemia.

Keywords: amisulpride; antipsychotics; macroprolactin; prolactin; risperidone; schizophrenia.

MeSH terms

  • Amisulpride
  • Antipsychotic Agents* / adverse effects
  • Humans
  • Hyperprolactinemia* / chemically induced
  • Hyperprolactinemia* / diagnosis
  • Hyperprolactinemia* / epidemiology
  • Prolactin
  • Risperidone / adverse effects
  • Schizophrenia* / complications
  • Schizophrenia* / drug therapy

Substances

  • Antipsychotic Agents
  • Amisulpride
  • Prolactin
  • Risperidone