Clinical Management of Antipsychotic-Induced Hyperprolactinemia.

Purpose: This article describes the physiology and mechanisms of prolactin and the assessment and clinical management strategies of antipsychotic-induced hyperprolactinemia.

Conclusions: Hyperprolactinemia is a disorder of the hypothalamic-pituitary axis which can be caused by several mechanisms. Typical antipsychotic agents are more likely to cause hyperprolactinemia than atypical antipsychotic agents, with the exception of amisulpride, paliperidone, and risperidone.

Practice Implications: Switching from prolactin-elevating to prolactin-sparing agents is recommended. Providing adjunctive treatment and prescribing substitutive hormones are alternatives. Education and lifestyle modification should be a major health promotion strategy. Taking patients' history and conducting physical examinations should be done during follow-up.