Hyperprolactinemia Associated with Drugs
At a Glance
Hyperprolactinemia is the most common endocrine disorder of the hypothalamic-pituitary unit. In premenopausal women, hyperprolactinemia causes hypogonadism, leading to symptoms of infertility, oligomenorrhea or amenorrhea, and galactorrhea. Hyperprolactinemia is often clinically silent in postmenopausal women who, by definition, are already hypogonadal. In men, hyperprolactinemia causes hypogonadism manifested by decreased libido, impotence, infertility, and, rarely, galactorrhea.
Several drugs are known to cause minimal to moderate hyperprolactinemia:
Selective serotonin reuptake inhibitors
H2-receptor blocking agents
Opiates and Opiate Antagonists
These should be ruled-out as potential causes of hyperprolactinemia prior to investigating organic causes.
What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?
Measurement of serum prolactin is necessary to identify hyperprolactinemia. Testing can be performed without regard to time of day, because routine daily activities have little influence on prolactin concentration.
Are There Any Factors That Might Affect the Lab Results? In particular, does your patient take any medications - OTC drugs or Herbals - that might affect the lab results?
Prolactin concentrations slightly greater than the reference interval should be confirmed by repeat testing on a new blood sample, because prolactin may be influenced by strenuous exercise, emotional or physical stress, or rigorous stimulation of breast tissue.
Macroprolactin is a complex of prolactin and IgG and is a source of hyperprolactinemia in some individuals. Because of its high molecular mass, macroprolactin has prolonged clearance that can cause an apparent hyperprolactinemia. In the absence of clinical symptoms, hyperprolactinemia due to macroprolactin can cause clinical confusion. It is important to be aware that macroprolactinemia can coexist with true hyperprolactinemia.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Differences in Efficacy and Tolerability of ADHD Medications Across Age Groups
- Associations Between Hypovitaminosis D and Poorer Outcomes in Schizophrenia
- Oxycontin's Maker Now Selling Drug to Curb Opioid Addiction
- Comorbid Narcolepsy and Schizophrenia in Adolescents
- FDA Approves New Treatment for Opioid Dependence
- Gestational Diabetes Associated With Increased Risk for Postpartum Depression
- Combination Cognitive Behavioral Therapy With Fluoxetine Effective for Adolescent Depression
- Smartphone-Based Psychoeducational Programs May Be Effective for Bipolar Disorder Management
- Prazosin May Be Effective as Treatment for Alcohol Use Disorder
- Risk Factors for Recurrent Suicide Attempts in Substance Use Disorder Outpatients