Clinical Implications of Antipsychotic-Induced Hyperprolactinemia in Patients With Schizophrenia Spectrum or Bipolar Spectrum Disorders: Recent Developments and Current Perspectives
Abstract
Hyperprolactinemia is increasingly studied as a frequent and potentially important consequence of antipsychotic medication treatment. Some individuals presenting with hyperprolactinemia remain asymptomatic, but others may exhibit a wide range of clinical symptoms resulting from either the direct effects of prolactin on body tissues (galactorrhea, gynecomastia) or endocrine-related secondary effects (sexual and reproductive dysfunction in the short term, and possibly the risk of tumorigenesis and osteoporosis in the longer term). Short-term side effects may negatively impact medication compliance, and long-term effects have the potential for serious health consequences. Antipsychotic medications have differing propensities to cause prolactin elevation. The first-generation antipsychotics, as well as the second-generation antipsychotic risperidone and its active metabolite paliperidone, have been shown to cause marked and sustained elevations in prolactin levels, whereas others of the second-generation antipsychotics appear to have little or no effect on prolactin levels or may decrease prolactin. A comprehensive overview of antipsychotics and hyperprolactinemia is presented together with a review of emerging evidence about the short- and long-term health risks of hyperprolactinemia.
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Clinical data implicating antipsychotic-induced hyperprolactinemia as a possible major risk factor for bone loss are limited and contradictory.
“Although it has been suggested that raised prolactin levels provoked by AP medication can lead to an increased risk of osteoporosis in patients with schizophrenia (471, 487), clinical data implicating AP-induced hyperprolactinemia as a possible major risk factor for bone loss are limited and contradictory (488,489).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [488]
The available data seem to indicate that hyperprolactinemia with associated hypogonadism may be a risk factor, leading to bone mineral loss in women as well as men.
“Nevertheless, the available data seem to indicate that hyperprolactinemia with associated hypogonadism may be a risk factor (488), leading to bone mineral loss in women as well as men (499).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [488]
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- Authors
- Byerly, M., Suppes, T., Tran, Q.-V., & Baker, R. A.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Otsuka (United States) (US)
- Bristol-Myers Squibb (United States) (US)
- Corresponding author
- Byerly, Matthew
- Suppes, Trisha
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2007-12
- Volume
- 27
- Issue
- 6
- Pages
- 639-661
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W1965091910
- Cited by
- 153
- References
- 184
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 3 · 2019: 3 · 2018: 7 · 2017: 10 · 2016: 10 · 2015: 11 · 2014: 11 · 2013: 10 · 2012: 9
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- antipsychotic-induced hyperprolactinemia, schizophrenia spectrum disorders, bipolar spectrum disorders, typical antipsychotics, atypical antipsychotics, risperidone, paliperidone, galactorrhea, gynecomastia, sexual dysfunction, reproductive disorders, carcinogenesis, osteoporosis, medication adherence, long-term health risks
- MeSH terms
- Bipolar Disorder, Humans, Hyperprolactinemia, Models, Biological, Psychopharmacology, Schizophrenia, Antipsychotic Agents, Meta-Analysis as Topic
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