Aripiprazole prolactin concentration

A 29-year-old woman with a schizoaffective disorder took haloperidol 5 mg/day and then 9 mg/day because of acute psychotic episodes. She had no adverse effects such as amenorrhea or galactorrhea. Haloperidol was then replaced by aripiprazole 15 mg/day and on the evening of the second day she developed breast tenderness and marked galactorrhea. The serum prolactin concentration was 32 ng/ml (reference range 5-25 ng/ ml). Aripiprazole was withdrawn and haloperidol restarted. The galactorrhea resolved in 1 week. 

Aripiprazole for 8 weeks has been used in 24 patients with hyperprolactinemia induced by risperidone, amisulpride, or sulpiride [132 ]. Prolactin concentrations fell from 77 to 18 ng/ml in those taking risperidone, from 145 to 128 in those taking amisulpride, and from 71 to 43 ng/ml in those taking sulpiride. Aripiprazole had no significant effect on metabolic measures or scales of movement adverse reactions. Nevertheless, it should be remembered that antipsychotic drug combinations are not approved for any indication. 

Placebo-controlled studies In a 6-week multicenter, double-blind, randomized, placebo-controlled study, patients aged 13-17 years with schizophrenia were assigned to aripiprazole (10 mg/day, n= 100 30 n day, n = 102) or placebo (n = 100) [59 ]. At the end of the study, both doses of aripiprazole significantly reduced PANSS total scores. Adverse events that occurred in more than 5% of subjects in either aripiprazole group and with a combined incidence at least twice the rate for placebo were extrapyramidal disorders, somnolence, and tremor. Mean changes in prolactin concentrations were... 

Endocrine Aripiprazole is said to stabilize the dopaminergic system and thus ameliorate schizophrenic symptoms without increasing serum prolactin [SEDA-31, 76]. Prolactin concentrations and sexual function in schizophrenic patients have been evaluated in an open, 26-week, multicenter study, in which 555 patients were randomized to aripiprazole ( = 284) or standard care (olanzapine, quetiapme, or risperidone n = 271) [69 ]. At 8 weeks, those who took aripiprazole reported significantly greater improvement in sexual function. Baseline mean serum prolactin concentrations were similar in the two groups (434 and 423 mg/1 respectively) however, at week 26, the mean fall in serum prolactin was 342 mg/1 with aripiprazole compared with 133 mg/1 with the other treatments. 

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