Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol

Jan Volavka, Pal Czobor, Thomas B. Cooper, Brian Sheitman, Jean Pierre Lindenmayer, Leslie Citrome, Joseph Patrick McEvoy, Jeffrey A. Lieberman

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Background: Prolactin levels are elevated to varying degrees by antipsychotics. Prolactin elevations may result in sexual and other adverse effects, and they may be related to antipsychotic effects. We used the data collected in a trial of antipsychotics to study the differential effect of these drugs on prolactin level, to explore the relation between clinical effects and prolactin level, and to determine the relationship between plasma levels of antipsychotics and prolactin level. Method: Treatment-resistant patients (133 men, 24 women) diagnosed with DSM-IV schizophrenia or schizoaffective disorder participated in a double-blind, randomized, 14-week trial comparing clozapine (N = 40), olanzapine (N = 39), risperidone (N = 41), and haloperidol (N = 37). Plasma levels of prolactin and antipsychotics were determined at baseline and at weeks 5, 8, 10, 12, and 14 during the trial. Clinical effects were measured with the Positive and Negative Syndrome Scale and the Extrapyramidal Symptom Rating Scale. Statistical analyses were limited to the 75 men for whom repeated prolactin levels were available. Data were gathered from June 1996 to December 1999. Results: Risperidone caused significant elevation of prolactin levels (p < .05) that appeared to be dose-dependent. Clozapine and olanzapine were associated with decreases of prolactin, whereas haloperidol led to a minor, nonsignificant increase. Plasma olanzapine and prolactin levels were correlated. Prolactin levels were not related to clinical improvement or extrapyramidal side effects. Conclusion: Antipsychotics show major differences in their effects on prolactin, and risperidone has clearly the most robust effect.

Original languageEnglish (US)
Pages (from-to)57-61
Number of pages5
JournalJournal of Clinical Psychiatry
Volume65
Issue number1
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

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olanzapine
Risperidone
Clozapine
Haloperidol
Prolactin
Psychotic Disorders
Schizophrenia
Antipsychotic Agents

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Volavka, J., Czobor, P., Cooper, T. B., Sheitman, B., Lindenmayer, J. P., Citrome, L., ... Lieberman, J. A. (2004). Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol. Journal of Clinical Psychiatry, 65(1), 57-61. https://doi.org/10.4088/JCP.v65n0109

Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol. / Volavka, Jan; Czobor, Pal; Cooper, Thomas B.; Sheitman, Brian; Lindenmayer, Jean Pierre; Citrome, Leslie; McEvoy, Joseph Patrick; Lieberman, Jeffrey A.

In: Journal of Clinical Psychiatry, Vol. 65, No. 1, 01.01.2004, p. 57-61.

Research output: Contribution to journalArticle

Volavka, Jan ; Czobor, Pal ; Cooper, Thomas B. ; Sheitman, Brian ; Lindenmayer, Jean Pierre ; Citrome, Leslie ; McEvoy, Joseph Patrick ; Lieberman, Jeffrey A. / Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol. In: Journal of Clinical Psychiatry. 2004 ; Vol. 65, No. 1. pp. 57-61.
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AU - Volavka, Jan

AU - Czobor, Pal

AU - Cooper, Thomas B.

AU - Sheitman, Brian

AU - Lindenmayer, Jean Pierre

AU - Citrome, Leslie

AU - McEvoy, Joseph Patrick

AU - Lieberman, Jeffrey A.

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N2 - Background: Prolactin levels are elevated to varying degrees by antipsychotics. Prolactin elevations may result in sexual and other adverse effects, and they may be related to antipsychotic effects. We used the data collected in a trial of antipsychotics to study the differential effect of these drugs on prolactin level, to explore the relation between clinical effects and prolactin level, and to determine the relationship between plasma levels of antipsychotics and prolactin level. Method: Treatment-resistant patients (133 men, 24 women) diagnosed with DSM-IV schizophrenia or schizoaffective disorder participated in a double-blind, randomized, 14-week trial comparing clozapine (N = 40), olanzapine (N = 39), risperidone (N = 41), and haloperidol (N = 37). Plasma levels of prolactin and antipsychotics were determined at baseline and at weeks 5, 8, 10, 12, and 14 during the trial. Clinical effects were measured with the Positive and Negative Syndrome Scale and the Extrapyramidal Symptom Rating Scale. Statistical analyses were limited to the 75 men for whom repeated prolactin levels were available. Data were gathered from June 1996 to December 1999. Results: Risperidone caused significant elevation of prolactin levels (p < .05) that appeared to be dose-dependent. Clozapine and olanzapine were associated with decreases of prolactin, whereas haloperidol led to a minor, nonsignificant increase. Plasma olanzapine and prolactin levels were correlated. Prolactin levels were not related to clinical improvement or extrapyramidal side effects. Conclusion: Antipsychotics show major differences in their effects on prolactin, and risperidone has clearly the most robust effect.

AB - Background: Prolactin levels are elevated to varying degrees by antipsychotics. Prolactin elevations may result in sexual and other adverse effects, and they may be related to antipsychotic effects. We used the data collected in a trial of antipsychotics to study the differential effect of these drugs on prolactin level, to explore the relation between clinical effects and prolactin level, and to determine the relationship between plasma levels of antipsychotics and prolactin level. Method: Treatment-resistant patients (133 men, 24 women) diagnosed with DSM-IV schizophrenia or schizoaffective disorder participated in a double-blind, randomized, 14-week trial comparing clozapine (N = 40), olanzapine (N = 39), risperidone (N = 41), and haloperidol (N = 37). Plasma levels of prolactin and antipsychotics were determined at baseline and at weeks 5, 8, 10, 12, and 14 during the trial. Clinical effects were measured with the Positive and Negative Syndrome Scale and the Extrapyramidal Symptom Rating Scale. Statistical analyses were limited to the 75 men for whom repeated prolactin levels were available. Data were gathered from June 1996 to December 1999. Results: Risperidone caused significant elevation of prolactin levels (p < .05) that appeared to be dose-dependent. Clozapine and olanzapine were associated with decreases of prolactin, whereas haloperidol led to a minor, nonsignificant increase. Plasma olanzapine and prolactin levels were correlated. Prolactin levels were not related to clinical improvement or extrapyramidal side effects. Conclusion: Antipsychotics show major differences in their effects on prolactin, and risperidone has clearly the most robust effect.

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