Is Second-Generation Antipsychotic–Induced Hyperprolactinemia Due to Biologically Active Prolactin or to Biologically Inactive Macroprolactin? Results From a Prospective Study
J Clin Psychiatry 2009;70(2):293-294 [letter]
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Letter to the Editor
Sir: Hyperprolactinemia is of particular concern with antipsychotic
medication, as symptoms associated with high prolactin
levels, e.g., sexual dysfunction, can have a negative
impact on the patient’s adherence to treatment, and has significant
implications for the short-term and long-term health of
patients. In general, second-generation antipsychotics (SGAs)
produce lower increases in prolactin levels than first-generation
antipsychotics due to the differences in these drugs’ binding affinity
for the dopamine D2 receptor. Particularly, olanzapine,
quetiapine, and clozapine have been shown to produce no significant
or sustained increase in prolactin. Conversely, SGAs
that have been associated with increases in prolactin levels are
amisulpride, zotepine, and risperidone.