Aripiprazole beats haloperidol-induced hyperprolactinaemia
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Aripiprazole beats haloperidolinduced hyperprolactinaemia Aripiprazole is effective for the treatment of haloperidol-induced hyperprolactinaemia among patients with schizophrenia, according to researchers from Korea and the US.1 Data were evaluated for 54 patients with schizophrenia and haloperidol-induced hyperprolactinaemia in the 8-week study. Patients were randomised to receive aripiprazole 15 mg/day for 4 weeks, then 30 mg/day for 4 weeks (n = 26), or placebo. All patients had been receiving a stable dose of haloperidol for ≥ 3 months. Throughout the study period, aripiprazole recipients had significantly lower prolactin levels than placebo recipients, demonstrating a significant time effect and a time-by-group interaction using repeated ANOVA measures. Moreover, a significantly greater proportion of aripiprazole than placebo recipients had normalised prolactin levels by week 8 (84.6% vs 3.6%). In addition, of 11 patients with menstrual disturbances who received aripiprazole, seven patients regained menstruation throughout the study, compared with none of 14 patients with menstrual disturbances who received placebo. In an accompanying editorial, Dr Robert M Kessler from the Vanderbilt University Medical Center, Tennessee, US, argues that the results of this study "demonstrate that aripiprazole functions as a partial dopamine D2 receptor agonist".2 He further contends that aripiprazole’s "high affinity for the dopamine D2 receptor allows it to successfully compete with haloperidol while providing sufficient agonism to reverse the haloperidol-induced hyperprolactinemia". He concludes that "its partial D2 receptor agonism provides decreased liability for extrapyramidal symptoms and hyperprolactinemia". 1. Shim J-C, et al. Adjunctive treatment with a dopamine partial agonist, aripiprazole, for antipsychotic-induced hyperprolactinemia: a placebo-controlled trial. American Journal of Psychiatry 164: 1404-1410, No. 9, Sep 2007. 2. Kessler RM. Aripiprazole: what is the role of dopamine D(2) receptor partial agonism? American Journal of Psychiatry 164: 1310-1312, No. 9, Sep 2007. 801099112
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Reactions 27 Oct 2007 No. 1175
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