Advanced Search

The American Journal of Psychiatry, VOL. 159, No. 9

Letter to the Editor | September 01, 2002

Prolactin Elevation With Quetiapine

MARIA ALEXIADIS, M.D.; DAVID WHITEHORN, PH.D., R.N., M.SC.N.; HAZEL WOODLEY, B.N.; LILI KOPALA, M.D., F.R.C.P.C.

Am J Psychiatry 2002;159:1608-1609. 10.1176/appi.ajp.159.9.1608

Article

References

text A A A

To the Editor: A recently published report by Peter Turrone, B.A. (Sp.H.), M.Sc., et al. (1) presented data indicating that the atypical antipsychotics risperidone, olanzapine, and clozapine produced serum prolactin elevations that were most prominent 1–5 hours after medication administration. With olanzapine and clozapine, serum prolactin levels had returned to baseline values by 12–24 hours. These findings have significant implications for understanding the binding properties of these compounds with dopamine D₂ receptors (2).

We completed a similar study to determine the effects of oral administration of quetiapine, another atypical antipsychotic, on serum prolactin levels in young first-episode patients with a schizophrenia spectrum disorder.

Four patients (two men and two women, mean age=21 years) participated. Each patient gave written informed consent. They were clinically stable with quetiapine monotherapy. All of the patients had been treated with quetiapine for more than 6 months. On the day of testing, they were instructed to withhold their morning dose of quetiapine and to come for testing at noon. Blood samples were drawn before the patients took their full daily dose (two patients were taking 700 mg/day, and two were taking 800 mg/day) and every 30 minutes thereafter for 3 hours.

Baseline serum prolactin levels were not abnormal (<10 ng/ml). However, all four patients had significant serum prolactin elevations within 90 minutes of drug administration. Two patients had peak prolactin levels (115 ng/ml and 120 ng/ml) occurring 60 minutes after they took the dose, while for the other two participants, peak levels (80 ng/ml and 84 ng/ml) occurred 90 minutes later. In all patients, serum prolactin levels declined from the peak value over the remaining observation times. Three hours after administration, serum prolactin levels (30 ng/ml to 60 ng/ml) were still above baseline levels in all four patients.

The magnitude of the prolactin elevations was considerably greater than what has been previously reported for risperidone, olanzapine, and clozapine (1). We administered the full daily dose of quetiapine to patients who had routinely received the drug in divided doses. Hence, the predicted serum prolactin elevations under the divided-dose regime would have been considerably lower than reported here and likely more comparable to the data for other atypical antidepressants.

These results indicate that oral administration of quetiapine was associated with a marked but transient increase in serum prolactin levels. The results support the view that a relatively rapid dissociation from dopamine receptors is central to the mechanism of action of atypical antipsychotics (2).

References

Turrone P, Kapur S, Seeman MV, Flint AJ: Elevation of prolactin levels by atypical antipsychotics. Am J Psychiatry 2002; 159:133-135[PubMed][CrossRef]

Seeman P: Atypical antipsychotics: mechanisms of action. Can J Psychiatry 2002; 47:27-38[PubMed]

Turrone P, Kapur S, Seeman MV, Flint AJ: Elevation of prolactin levels by atypical antipsychotics. Am J Psychiatry 2002; 159:133-135[PubMed][CrossRef]

Seeman P: Atypical antipsychotics: mechanisms of action. Can J Psychiatry 2002; 47:27-38[PubMed]

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.

Submit a Comments

Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of JBJS editorial staff.

* = Required Field

Comment Author(s)*(if multiple authors, separate names by comma)

Example: John Doe

Affiliation & Institution*

Comment Title*

Comment*

Cancel

Print
E-mail

Recipient(s) will receive an email with a link (good for 72 hours) to 'Prolactin Elevation With Quetiapine' and do not need to have American Journal of Psychiatry account to access the content.
Your Name:*
Example: John Doe

Email Address:* CC Me:
Enter your valid email address. Example: jdoe@example.com

Recipient's Email Address:*
Separate multiple email address with semi-colons (up to 5).

Subject:* 's American Journal of Psychiatry: 'Prolactin Elevation With Quetiapine'
Subject for your email.

Message:
(Optional, message will truncate at 1000 characters)

Processing your request... Please Wait...

Copyright © in the material you requested is held by The American Psychiatric Association (unless otherwise noted). This email ability is provided as a courtesy, and by using it you agree that you are requesting the material solely for personal, non-commercial use, and that it is subject to The American Psychiatric Association's Terms of Use. The information provided in order to email this topic will not be used to send unsolicited email, nor will it be furnished to third parties. Please refer to The American Psychiatric Association's Privacy Policy for further information.

Copyright © American Psychiatric Association. All rights reserved.
Share
Get Citation

MARIA ALEXIADIS, DAVID WHITEHORN, HAZEL WOODLEY, LILI KOPALA; Prolactin Elevation With Quetiapine. American Journal of Psychiatry. 2002 Sep;159(9):1608-1609.

Download citation file:

RIS (Zotero)

EndNote

BibTex

Medlars

ProCite

RefWorks

Reference Manager

Copyright © American Psychiatric Association. All rights reserved.
Reprints