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The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia.
Clin Ther. 2000 Sep; 22(9):1085-96.CT

Abstract

BACKGROUND

There is relatively little comparative information on elevations in plasma prolactin level (PRL) with conventional versus novel antipsychotic agents.

OBJECTIVE

This paper examines the comparative effects on PRL of olanzapine, risperidone, and haloperidol based on data from 3 multicenter, double-blind, randomized clinical trials. Magnitude of response, dose dependency, time course, effects of sex and age, and response to switching from haloperidol to olanzapine are assessed.

METHODS

The effects of olanzapine, risperidone, and haloperidol on PRL were assessed in patients with schizophrenia or related psychoses participating in 3 double-blind clinical trials: (1) a 6-week acute trial comparing olanzapine 5 to 20 mg/d (n = 1,336) and haloperidol 5 to 20 mg/d (n = 660), with a 1-year, open-label olanzapine extension for responders; (2) a 54-week study comparing olanzapine 5 to 20 mg/d (n = 21), risperidone 4 to 10 mg/d (n = 21), and haloperidol 5 to 20 mg/d (n = 23) in early illness; and (3) a 28-week study comparing olanzapine 10 to 20 mg/d (n = 172) and risperidone 4 to 12 mg/d (n = 167).

RESULTS

PRL elevations were significantly greater with risperidone than with either olanzapine or haloperidol in study 2. and significantly greater than with olanzapine in study 3 (all, P < 0.001). PRL elevations were significantly greater with haloperidol than with olanzapine in study 1 (P < 0.001). A dose-response relationship was not consistently confirmed with any of the drug treatments. Risperidone-associated PRL elevations peaked relatively early in treatment. In haloperidol- and risperidone-treated patients, the mean change in PRL was greater in women than in men. PRL decreased significantly when treatment was switched from haloperidol to olanzapine.

CONCLUSIONS

This side-by-side analysis of 3 independent studies suggests that with the 3 antipsychotic drugs studied, PRL is elevated moderately by olanzapine (mean change, 1-4 ng/mL), intermediately by haloperidol (mean change, approximately 17 ng/mL), and strongly by risperidone (mean change, 45-80 ng/mL). No consistent dose-response relationship was observed, and the time course and sex-dependency of the response differed between the 3 agents. Patients with haloperidol-induced hyperprolactinemia may benefit from a switch to olanzapine. Long-term studies examining the health consequences of chronic hyperprolactinemia during antipsychotic treatment are needed.

Links

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Authors+Show Affiliations

David SR
Lilly Research Laboratories, Eli Lilly and Company, Eli Corporate Center, Indianapolis, Indiana 46285 USA. David_Stacy@lilly.com
Taylor CC
No affiliation info available
Kinon BJ
No affiliation info available
Breier A
No affiliation info available

MeSH

Antipsychotic AgentsBenzodiazepinesCross-Over StudiesDose-Response Relationship, DrugHaloperidolHumansOlanzapinePirenzepineProlactinRisperidoneSchizophrenia

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

11048906

Citation

David, S R., et al. "The Effects of Olanzapine, Risperidone, and Haloperidol On Plasma Prolactin Levels in Patients With Schizophrenia." Clinical Therapeutics, vol. 22, no. 9, 2000, pp. 1085-96.
David SR, Taylor CC, Kinon BJ, et al. The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. Clin Ther. 2000;22(9):1085-96.
David, S. R., Taylor, C. C., Kinon, B. J., & Breier, A. (2000). The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. Clinical Therapeutics, 22(9), 1085-96.
David SR, et al. The Effects of Olanzapine, Risperidone, and Haloperidol On Plasma Prolactin Levels in Patients With Schizophrenia. Clin Ther. 2000;22(9):1085-96. PubMed PMID: 11048906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. AU - David,S R, AU - Taylor,C C, AU - Kinon,B J, AU - Breier,A, PY - 2000/10/26/pubmed PY - 2001/2/28/medline PY - 2000/10/26/entrez SP - 1085 EP - 96 JF - Clinical therapeutics JO - Clin Ther VL - 22 IS - 9 N2 - BACKGROUND: There is relatively little comparative information on elevations in plasma prolactin level (PRL) with conventional versus novel antipsychotic agents. OBJECTIVE: This paper examines the comparative effects on PRL of olanzapine, risperidone, and haloperidol based on data from 3 multicenter, double-blind, randomized clinical trials. Magnitude of response, dose dependency, time course, effects of sex and age, and response to switching from haloperidol to olanzapine are assessed. METHODS: The effects of olanzapine, risperidone, and haloperidol on PRL were assessed in patients with schizophrenia or related psychoses participating in 3 double-blind clinical trials: (1) a 6-week acute trial comparing olanzapine 5 to 20 mg/d (n = 1,336) and haloperidol 5 to 20 mg/d (n = 660), with a 1-year, open-label olanzapine extension for responders; (2) a 54-week study comparing olanzapine 5 to 20 mg/d (n = 21), risperidone 4 to 10 mg/d (n = 21), and haloperidol 5 to 20 mg/d (n = 23) in early illness; and (3) a 28-week study comparing olanzapine 10 to 20 mg/d (n = 172) and risperidone 4 to 12 mg/d (n = 167). RESULTS: PRL elevations were significantly greater with risperidone than with either olanzapine or haloperidol in study 2. and significantly greater than with olanzapine in study 3 (all, P < 0.001). PRL elevations were significantly greater with haloperidol than with olanzapine in study 1 (P < 0.001). A dose-response relationship was not consistently confirmed with any of the drug treatments. Risperidone-associated PRL elevations peaked relatively early in treatment. In haloperidol- and risperidone-treated patients, the mean change in PRL was greater in women than in men. PRL decreased significantly when treatment was switched from haloperidol to olanzapine. CONCLUSIONS: This side-by-side analysis of 3 independent studies suggests that with the 3 antipsychotic drugs studied, PRL is elevated moderately by olanzapine (mean change, 1-4 ng/mL), intermediately by haloperidol (mean change, approximately 17 ng/mL), and strongly by risperidone (mean change, 45-80 ng/mL). No consistent dose-response relationship was observed, and the time course and sex-dependency of the response differed between the 3 agents. Patients with haloperidol-induced hyperprolactinemia may benefit from a switch to olanzapine. Long-term studies examining the health consequences of chronic hyperprolactinemia during antipsychotic treatment are needed. SN - 0149-2918 UR - https://www.unboundmedicine.com/medline/citation/11048906/The_effects_of_olanzapine_risperidone_and_haloperidol_on_plasma_prolactin_levels_in_patients_with_schizophrenia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(00)80086-7 DB - PRIME DP - Unbound Medicine ER -