Antipsychotics and hyperprolactinaemia

Antipsychotic drug-induced hyperprolactinemia is common - the reported range varies between 18% and 72% in men and 42% and 93% in women. (1)

First-generation antipsychotic drugs such as haloperidol, chlorpromazine, and sulpiride are associated with increased prolactin. (2)

Among the second-generation antipsychotic drugs, amisulpiride, risperidone, and paliperidone cause a considerable increase in serum prolactin. (2)

Based on the risk, the order of the top five antipsychotic drugs is risperidone, amisulpiride, paliperidone, fluphenazine, and haloperidol. (3) Asenapine, clozapine, quetiapine, and olanzapine are less frequently associated with hyperprolactinemia, and aripiprazole decreases the level. (4)

Reference

1. Jiang Q, Li T, Zhao L, Sun Y, Mao Z, Xing Y, et al. Treatment of antipsychotic-induced hyperprolactinemia: An umbrella review of systematic reviews and meta-analyses. Front Psychiatry. 2024;15:1337274.
2. Zhu Y, Zhang C, Siafis S, Zhuo K, Zhu D, Wu H, et al. Prolactin levels influenced by antipsychotic drugs in schizophrenia: A systematic review and network meta-analysis. Schizophr Res. 2021;237:20-5.
3. Song M, Li D, Peng J, Wang N, Zhang M, Ren XL. A disproportionality analysis of antipsychotic-induced hyperprolactinemia based on FDA adverse event reporting system. Int J Clin Pharmacol Ther. 2024;62:543-52.
4. Ghahramani A, Bellon A. Monitoring prolactin in patients taking antipsychotics. Front Psychiatry. 2024;15:1333280