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Hyperprolactinemia in antipsychotic-naive patients with first-episode psychosis

Published online by Cambridge University Press:  18 April 2013

A. Riecher-Rössler ,
J. K. Rybakowski ,
M. O. Pflueger ,
R. Beyrau ,
R. S. Kahn ,
P. Malik  and
W. W. Fleischhacker
A. Riecher-Rössler*
Affiliation:
University of Basel Psychiatric Clinics, Basel, Switzerland
J. K. Rybakowski
Affiliation:
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
M. O. Pflueger
Affiliation:
University of Basel Psychiatric Clinics, Basel, Switzerland
R. Beyrau
Affiliation:
Department of Clinical Chemistry, University Hospital Basel, Switzerland
R. S. Kahn
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands
P. Malik
Affiliation:
Department of Biological Psychiatry, Medical University Innsbruck, Austria
W. W. Fleischhacker
Affiliation:
Department of Biological Psychiatry, Medical University Innsbruck, Austria
*
*Address for correspondence: Prof. Dr med. A. Riecher-Rössler, Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, c/o University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. (Email: anita.riecher@upkbs.ch)
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Abstract

Background

Hyperprolactinemia is frequent in patients with schizophrenic psychoses. It is usually regarded as an adverse effect of antipsychotics but has recently also been shown in patients without antipsychotic medication. Our objective was to test whether hyperprolactinemia occurs in antipsychotic-naive first-episode patients (FEPs).

Method

In the framework of the European First Episode Schizophrenia Trial (EUFEST), 249 out of 498 FEPs were eligible for this study, of whom 74 were antipsychotic naive. All patients were investigated regarding their serum prolactin levels with immunoassays standardized against the 3rd International Reference Standard 84/500.

Results

Twenty-nine (39%) of the 74 antipsychotic-naive patients showed hyperprolactinemia not explained by any other reason, 11 (50%) of 22 women and 18 (35%) of 52 men.

Conclusions

Hyperprolactinemia may be present in patients with schizophrenic psychoses independent of antipsychotic medication. It might be stress induced. As enhanced prolactin can increase dopamine release through a feedback mechanism, this could contribute to explaining how stress can trigger the outbreak of psychosis.

Keywords

Antipsychoticdopaminefirst-episode psychosisprolactinschizophreniastress
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 12 , December 2013 , pp. 2571 - 2582
Copyright
Copyright © Cambridge University Press 2013 

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