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Re: Amisulpride and prolactin » Darwin

Posted by rina on September 22, 2007, at 2:50:04

In reply to Re: Amisulpride and prolactin » Amigan, posted by Darwin on September 21, 2007, at 21:29:07

Unfortunately Amisulpride isn't the only one in that category.
In general, second-generation antipsychotics produce lower increases in prolactin than conventional agents.[3] Some agents, including olanzapine,[29,35] quetiapine,[36,37] ziprasidone[38,39] and clozapine[40,41] have been shown to produce no significant or sustained increase in prolactin in adult patients.

However, in adolescents (age 9-19 years) treated for childhood-onset schizophrenia or psychotic disorder, it has been shown that after 6 weeks of olanzapine treatment prolactin levels were increased beyond the upper limit of the normal range in 70% of patients.

The authors concluded that further studies involving second-generation antipsychotics in adolescent patients, with longer observation intervals and bigger samples, were required.[42]

Second-generation antipsychotics that have been associated with increases in prolactin levels are amisulpride, zotepine and risperidone[43- 45]. An analysis of double-blind studies of risperidone in schizophrenic patients showed that this drug dose-dependently increased prolactin concentrations in both men and women.

However, the increase was not associated with the occurrence of adverse events.[43] Furthermore, a significant prolactin increase was observed in an open study in which patients were switched from haloperidol to risperidone.[46] In schizophrenia patients treated with amisulpride for 12 months, prolactin secretion was significantly increased over baseline after 1 month of high dosing (1000 mg/day) during the acute phase.

Prolactin levels remained elevated above baseline for the 12-month dosing period but gradually declined during the maintenance phase (amisulpride 200-600mg/day).[44] However, a review of 11 studies, which involved a total of 1247 patients treated with amisulpride, concluded that the incidence of endocrine-related adverse events was similar for amisulpride, haloperidol, risperidone and placebo (Figure 3).

Furthermore, the study concluded that the safety profile of amisulpride was comparable to that of risperidone and superior to conventional antipsychotics, including haloperidol.[47] Finally, Fleischhacker and colleagues[45] found increased prolactin levels investigating the efficacy of zotepine in the treatment of negative symptoms.
http://www.medscape.com/viewarticle/468929_4


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