AI Article Synopsis
- Different therapeutic strategies like switching antipsychotics, adding aripiprazole, dopamine agonists, or metformin are explored to lower prolactin levels in psychotic disorder patients with antipsychotic-induced hyperprolactinaemia.
- A meta-analysis indicated that adding aripiprazole is the most effective strategy, showing a significant reduction in prolactin levels compared to placebo and current treatment methods.
- Withdrawal rates for aripiprazole and placebo were similar, suggesting it is a viable option for managing hyperprolactinaemia in schizophrenia patients.*
Article Abstract
Different therapeutic strategies are used for lowering prolactin concentrations in patients with psychotic disorders with antipsychotic-induced hyperprolactinaemia. We aimed to examine the evidence from open-label studies and randomized clinical trials (RCTs) that studied four prolactin-lowering therapeutic strategies in people with psychotic disorders and hyperprolactinaemia: 1) switching to prolactin-sparing antipsychotics; 2) adding aripiprazole; 3) adding dopamine agonists; and 4) adding metformin. RCTs were included in a meta-analysis. Effect sizes (Hedges' g) of prolactin reductions with each strategy were calculated. Withdrawal rates were also considered. We identified 26 studies. Nine studies explored switching antipsychotic treatment to aripiprazole (n = 4), olanzapine (n = 1), quetiapine (n = 2), paliperidone palmitate (n = 1) or blonanserin (n = 1). Twelve studies tested the addition of aripiprazole. Six studies explored the addition of cabergoline (n = 3), bromocriptine (n = 2) or terguride (n = 1). We also found one meta-analysis testing the addition of metformin to antipsychotic treatment but no other individual studies. A meta-analysis could only be performed for the addition of aripiprazole, the strategy with the best level of evidence. Five RCTs testing the addition of aripiprazole yielded a significant reduction in prolactin concentration compared to placebo (N = 3) or maintaining antipsychotic treatment (N = 2): Hedges' g was -1.35 (CI 95%: -1.93 to -0.76, p < 0.001). The three placebo-controlled RCTs for aripiprazole addition showed similar withdrawal rates for aripiprazole (10.1%) and placebo (11.5%), without significant differences in the meta-analysis. Our study suggests that, in terms of levels of evidence, adding aripiprazole is the first option to be considered for lowering prolactin concentrations in patients with schizophrenia and hyperprolactinaemia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.schres.2020.04.031 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Negative Symptoms in Schizophrenia: An Update on Research Assessment and the Current and Upcoming Treatment Landscape.
CNS Drugs
January 2025
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
The negative symptoms of schizophrenia include diminished emotional expression, avolition, alogia, anhedonia, and asociality, and due to their low responsiveness to available treatments, are a primary driver of functional disability in schizophrenia. This narrative review has the aim of providing a comprehensive overview of the current research developments in the treatment of negative symptoms in schizophrenia, and begins by introducing the concepts of primary, secondary, prominent, predominant, and broadly defined negative symptoms. We then compare and contrast commonly used research assessment scales for negative symptoms and review the evidence for the specific utility of widely available off-label and investigational treatments that have been studied for negative symptoms.
View Article and Find Full Text PDFEffects of lithium carbonate combined with olanzapine on glucose and lipid metabolism in the treatment of bipolar disorder and gender differences.
Pak J Pharm Sci
January 2025
Department of Psychiatry, the Fifth People's Hospital of Luoyang, Luoyang City, Henan Province.
To explore the effect of lithium carbonate combined with olanzapine on glucose and lipid metabolism, as well as gender differences in treating bipolar disorder (BD). 110 BD patients admitted to the Fifth People's Hospital of Luoyang from February 2022 to January 2024 were retrospectively included in the study. Patients were categorized into two groups based on treatment: The single group (lithium carbonate, n = 50) and the coalition group (lithium carbonate + olanzapine, n=60).
View Article and Find Full Text PDFTherapeutic effects of chiglitazar combined with Rosa roxburghii Tratt. in inpatients with antipsychotic-induced metabolic syndrome.
Pak J Pharm Sci
January 2025
Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China.
The objective of this study was to evaluate the therapeutic effects of Chiglitazar combined with Rosa roxburghii Tratt (RRT) in inpatients diagnosed with psychiatric disorders and antipsychotic-induced metabolic syndrome (MetS).100 cases were included and divided into the Siglitazar group (n=50) and the Siglitazar + RRT group (n=50) Anthropometric measurements, lipid and glucose metabolism indicators, inflammatory markers and PANSS scores were assessed at baseline, 8 weeks and 12 weeks post-treatment. Both treatment groups exhibited significant reductions in waist circumference and improvements in lipid profiles and glucose metabolism indicators over the 12-week study period.
View Article and Find Full Text PDFFrom Antipsychotic to Neuroprotective: Computational Repurposing of Fluspirilene as a Potential PDE5 Inhibitor for Alzheimer's Disease.
J Comput Chem
January 2025
Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, New South Wales, Australia.
Phosphodiesterase 5 (PDE5) inhibitors have shown great potential in treating Alzheimer's disease by improving memory and cognitive function. In this study, we evaluated fluspirilene, a drug commonly used to treat schizophrenia, as a potential PDE5 inhibitor using computational methods. Molecular docking revealed that fluspirilene binds strongly to PDE5, supported by hydrophobic and aromatic interactions.
View Article and Find Full Text PDFComparative Analysis of Serum BAFF and IL-17 Levels Pre- and Post-Antipsychotic Treatment for Acute Schizophrenia.
Int J Mol Sci
January 2025
Research Laboratory LR12ES04, Faculty of Medicine of Sousse, University of Sousse, Sousse 4002, Tunisia.
The interplay between the cytokine network and antipsychotic treatment in schizophrenia remains poorly understood. This study aimed to investigate the impact of psychotropic medications on serum levels of IFN-γ, IL-4, TGF-β1, IL-17, and BAFF, and to explore their relationship with psychopathological features. We recruited 63 patients diagnosed with schizophrenia in the acute phase, all of whom were either drug-naïve or had been drug-free for at least three months.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!