Female puberty: Clinical implications for the use of prolactin-modulating psychotropics
Female puberty: Clinical implications for the use of prolactin-modulating psychotropics
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DOI：
10.1016/j.chc.2005.08.006
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发表时间：
2006-01-01
影响因子：
2.4
通讯作者：
Epperson, CN
中科院分区：
文献类型：
--
作者：
Becker, AL;Epperson, CN
Puberty is a complex time in human development. As neuroendocrine functioning awakens, the capacity for reproduction develops, and skeletal mass and bone mineral density (BMD) increase. In the context of this dynamic process, girls may present with psychiatric illness necessitating treatment with psychotropic medications. Pubertal girls are especially vulnerable to medication-associated adverse events. Atypical antipsychotic (AAP) medications and antidepressants have the potential to elevate serum prolactin (PR-L) levels, and hyperprolactinemia has the potential to alter the tempo of the pubertal progression and to inhibit the achievement of important developmental milestones. Clinicians must incorporate existing knowledge of normal pubertal development and evidence from clinical trials and case reports to optimize treatment outcomes. Selection of PRL-sparing AAP medications is recommended, as is treatment with the lowest effective dose of selective serotonin reuptake inhibitors (SSRIs). In addition, because many pubertal girls lack the capacity to express outward signs of hypothalamic-pituitary-gonadal (HPG) dysfunction such as galactorrhea or menstrual irregularities, monitoring of serum PRL levels may be necessary to rule out chronic hyperprolactinemia and to prevent the loss of developmentally critical bone mineral deposit.
