Benedicto Crespo-Facorro1, Victor Ortiz-Garcia de la Foz2, Paula Suarez-Pinilla3, Elsa M Valdizan4, Rocío Pérez-Iglesias5, Jose Antonio Amado-Señaris6, M Teresa Garcia-Unzueta7, Javier Labad8, Christopher Correll9, Rosa Ayesa-Arriola2. 1. 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. 2. 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. 3. University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain. 4. CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Physiology and Pharmacology, and IBBTEC (UC-CSIC-SODERCAN), University of Cantabria, Spain. 5. 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. 6. Department of Endocrinology, Marqués de Valdecilla University Hospital, Avda. Valdecilla s/n, 39008, University of Cantabria, Spain. 7. Department of Biochemistry, Marques de Valdecilla University Hospital, Santander 39008, Spain. 8. 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. 9. 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.
Abstract
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 onaripiprazole 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 (χ2=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.
RCT Entities:
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 (χ2=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.
Authors: David D Kim; Alasdair M Barr; Lulu Lian; Jessica W Y Yuen; Diane Fredrikson; William G Honer; Allen E Thornton; Ric M Procyshyn Journal: NPJ Schizophr Date: 2021-05-25
Authors: Benedicto Crespo-Facorro; Miguel Ruiz-Veguilla; Javier Vázquez-Bourgon; Ana C Sánchez-Hidalgo; Nathalia Garrido-Torres; Jose M Cisneros; Carlos Prieto; Jesus Sainz Journal: Front Pharmacol Date: 2021-03-02 Impact factor: 5.810
Authors: María Hidalgo-Figueroa; Alejandro Salazar; Cristina Romero-López-Alberca; Karina S MacDowell; Borja García-Bueno; Miquel Bioque; Miquel Bernardo; Mara Parellada; Ana González-Pinto; María Paz García Portilla; Antonio Lobo; Roberto Rodriguez-Jimenez; Esther Berrocoso; Juan C Leza Journal: Int J Neuropsychopharmacol Date: 2022-08-16 Impact factor: 5.678