Evaluation of prolactin levels of schizophrenia patients with antipsychotic-induced hyperprolactinemia, after addition of aripiprazole and aripiprazole monotherapy

Antipsychotic drugs are the basic treatments of schizophrenia. One of themost common and important endocrine side effect of antipsychotics ishyperprolactinemia. Both typical and most of the atypical antipsychotics causehyperprolactinemia by blockage of dopamine D2 receptors.As with the other side effects, hyperprolactinemia is usually notconsidered as important and followed up during patient evaluations. Yet,hyperprolactinemia causes galactorrhoea, amenorrhea, gynecomastia, infertility,sexual dysfunction in acute term, as well as serious diseases such as osteoporosis,osteopenia, pituitary tumors, breast and endometrium cancers in chronic term.Physical and emotional adverse events induced by hyperprolactinemia maycause disturbance of physical and mental health, as well as adjustment problemseffecting the treatment adherence. Treatment and follow-up are needed as soon asestablished. Macroprolactin levels should be evaluated in cases ofhyperprolactinemia since it may also be caused by antipsychotic usage and it isusually not considered as a need for further evaluation and treatment by mostresearchers, since it does not have biological activity.In this study, aripiprazole, an antipsychotic which is thought to lowerprolactin levels by partial agonistic mechanism, was given to patients diagnosedwith schizophrenia and who has antipsychotic-induced hyperprolactinemia, both96as a combination treatment or monotherapy. As well as monitorization ofprolactin levels and psychopathology, macroprolactin frequency and itsrelationship between hyperprolactinemia symptoms were also evaluated.According to our results; in monotherapy group elevated prolactin levelswere significantly decreased, while in combination group there was no significantdecline in prolactin levels, which continued to be high. In monotherapy group,there was no significant positive change in psychopathology, while incombination group a non-significant change was noticed in favor of improvement.In addition, macroprolactinemia was found in 4 patients, and there was norelationship between macroprolactinemia and hyperprolactinemia symptoms.Our results show that; in patients with hyperprolactinemia, aripiprazolemonotherapy may cause a decline of prolactin levels without an effect onpsychopathology, while combination may cause a slight improvement in terms ofpsychopathology without effecting prolactin levels, patients withhyperprolactinemia may also have macroprolactinemia but it is not related tohyperprolactinemia symptoms.Key words: Hyperprolactinemia, antipsychotics, schizophrenia, aripiprazole,macroprolactin.