Antipsychotics and Hyperprolactinemia: Prevalence and Risk Factors

Hyperprolactinemia, a largely underestimated frequent endocrine disorder, may be due to various causes including different treatments. Antipsychotics, particularly, play a major role in its occurence. Ours Objectives are to estimate the prevalence of hyperprolactinemia among patients treated with a single antipsychotic and to specify the risk factors for its occurence. It’s a cross-sectional study over a 6-month period realized at the Psychiatry Department of Mahdia Hospital, Tunisia on outpatients treated with a single antipsychotic on stable doses for 12 weeks and fulfilling the inclusion and exclusion criteria. A dosage of plasma prolactin levels was carried out then confirmed by a second dosage in case of abnormal levels in the first one. A Magnetic Resonance Imaging (MRI) of the pituitary gland was performed for patients with prolactin levels higher than 150ng/ml. The study of 92 patient’s files, the prevalence showed that of patients had hyperprolactinemia 34.8% and 7.6% had prolactin levels higher than 150ng/ml. An MRI of the pituitary gland was performed for these latter which revealed 2 cases of macro adenoma. The analytic study concluded that 7 factors were significantly correlated with hyperprolactinemia. These factors were as follow : gender female ; consumption of psychoactive substances; side effects of antipsychotic; prescription of atypical antipsychotic; the nature of the prescribed antipsychotic: Haloperidol/ Amisulpride, an antipsychotic dose higher than equivalent 1000 mg of chlorpromazine and the association of psychotropic drugs. Antipsychotics induced hyperprolactinemia has not been adequately evaluated and despite its frequency, and clinical consequences such as sexual disorders.