Endocrine Abstracts

Objectives: To assess prevalence of antipsychotic-induced hyperpolactinemia (AIH) in psychiatric in-patients and to describe its clinical characteristics and association of AIH with sexual function.

Methods: A cross-sectional study in 143 consecutive psychiatric in-patients (F/M=65/78), mostly with schizophrenia (93%), currently taking antipsychotics. The patients were screened for serum prolactin, sex hormones, gonadotropin levels and macroprolactin. For assessment of any sexual dysfunction, UKU side effects rating scale (UKU), Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) were used.

Results: Overall prevalence of AIH was 57.0% (F, 72.0%; M, 43.6%). Macroprolactin was extremely rare (one patient only, 2.0%). AIH was asymptomatic in 19% of females and in 54% of males. Hyperprolactinemic women had a higher rate of menstrual dysfunction (56 vs 14%, P=0.006) and galactorrhea (66 vs 0%, P<0.001), compared to normoprolactinemic. Prolactin level inversely correlated with that of estradiol (R=−0.35, P=0.03) and correlated positively with PRSexDQ score of questions on the impact of sexual dysfunction on quality of life (R=0.35, P=0.02). For assessment of sexual dysfunction, males were divided into two age groups: 19–31 and 32–45 years. Hyperprolactinemic men in the younger age group had a higher UKU score of questions on increased sexual desire (P=0.026) compared with normoprolactinemic of the same age group. In the younger, but not in the older age group, prolactin level correlated positively with UKU score in questions about reduced sexual desire (R=0.35, P=0.029). There were no association between AIH and weight gain and/or obesity in patients of both genders.

Conclusions: AIH found by screening is more than 1.5-fold prevalent than that diagnosed by referral. In patients with AIH, measurement of macroprolactin is unnecessary. AIH cause menstrual disorders (oligomenorrhea and amenorrhea), galactorrhea and decreased estradiol level in females. AIH per se does not lead to weight gain and obesity. AIH is associated with sexual dysfunction in females, affecting their quality of life. AIH is associated with change of libido (increasing or reducing) in males 19–31 years old.