Dose-Dependent Effects of Adjunctive Treatment With Aripiprazole on Hyperprolactinemia Induced by Risperidone in Female Patients With Schizophrenia
Dose-Dependent Effects of Adjunctive Treatment With Aripiprazole on Hyperprolactinemia Induced by Risperidone in Female Patients With Schizophrenia
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DOI：
10.1097/jcp.0b013e3181ee832d
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发表时间：
2010-10-01
影响因子：
2.9
通讯作者：
Kaneko, Sunao
中科院分区：
文献类型：
--
作者：
Yasui-Furukori, Norio;Furukori, Hanako;Kaneko, Sunao
高催乳素血症是利培酮治疗的常见后果。最近的研究表明，阿立哌唑是一种部分多巴胺激动剂，可以降低催乳素对抗精神病药物的反应。因此，我们研究了阿立哌唑辅助治疗对因利培酮治疗而导致催乳素水平升高的患者血浆催乳素浓度的剂量效应。阿立哌唑联合利培酮2~15 mg/d治疗女性精神分裂症16例。阿立哌唑的剂量从3 mg/d逐渐增加到12 mg/d，间隔2~4周。在阿立哌唑给药前(基线)、阿立哌唑剂量递增后2-4周和下一剂量递增前采集催乳素样本。这些样本是在早上服药前采集的。阿立哌唑治疗(3、6、9、12 mg/d)时血浆催乳素浓度显著低于治疗前。3、6、9和12 mg/d的平均(TSD)下降百分比分别为35%+/-14%、54%+/-17%、57%+/-19%和63%+/-17%。阿立哌唑6 mg/d、9 mg/d和12 mg/d三个剂量组的催乳素血药浓度和血浆催乳素降解率均无差异。8例闭经患者中有3例在服用阿立哌唑12 mg/d后改善。本研究提示阿立哌唑辅助治疗可降低因利培酮治疗而升高的催乳素浓度。即使使用低剂量(3 mg/d)的阿立哌唑也会产生这种效果，当剂量超过6 mg/d时，效果会达到平台期。
Hyperprolactinemia is a frequent consequence of treatment with risperidone. Recent studies have suggested that aripiprazole, a partial dopamine agonist, reduces the prolactin response to antipsychotics. Thus, we examined the dose effects of adjunctive treatment with aripiprazole on the plasma concentration of prolactin in patients who had elevated prolactin levels because of risperidone treatment. Aripiprazole was concomitantly administrated to 16 female patients with schizophrenia receiving 2 to 15 mg/d of risperidone. Dosages of aripiprazole were gradually increased from 3 to 12 mg/d with 2- to 4-week intervals. Sample collections for prolactin were conducted before aripiprazole administration (baseline) and 2 to 4 weeks after the dose escalation of aripiprazole and just before next dose escalation. The samples were taken just before the morning dose. The plasma concentration of prolactin during aripiprazole administration (3, 6, 9, or 12 mg/d) was significantly lower than that at baseline. The mean (TSD) percent reductions at 3, 6, 9, and 12 mg/d were 35% +/- 14%, 54% +/- 17%, 57% +/- 19%, and 63% +/- 17%, respectively. However, neither the plasma concentration of prolactin nor the reduction ratio differed among the dosages of 6, 9, and 12 mg/d of aripiprazole. Three out of 8 patients with amenorrhea improved after 12 mg/d of aripiprazole. The present study suggests that adjunctive treatment with aripiprazole reduces the prolactin concentration that had been increased because of risperidone treatment. The effect occurs even when a low dosage (3 mg/d) of aripiprazole was used and achieves a plateau at dosages beyond 6 mg/d.