Assessment of Hyperprolactinemia in Drug Naive Patients with Depression

Abstract

Introduction: Patients with hyperprolactinemia often present with emotional difficulties, which occasionally persist even after treatment with dopamine agonists. There is an unusual prevalence of hyperprolactinemia in patients with depressive disorder. Prolactin is a hormone of the anterior pituitary and its secretion is regulated by Thyrotropin-Releasing Hormone (TRH) and Dopamine. Several studies have shown that antidepressants that inhibit serotonin reuptake can cause hyperprolactinemia which in turn leads to several complications like galactorrhoea, sexual dysfunction and several hormonal imbalances. This study was envisaged to assess baseline prolactin levels before administering any antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs) in patients with depression. Aim: To assess serum prolactin level in drug naive patients with depression attending psychiatric Out Patient Department (OPD) of a tertiary care hospital and to compare its level with healthy controls. Materials and Methods: The present study was a cross-sectional, descriptive hospital based study. The duration of the study was 12 months. The study was conducted at the Department of Biochemistry and Psychiatry OPD of College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India. Forty drug naive depression patients were selected as cases and 40 age and sex matched healthy individuals randomly were taken as controls. Results: A total of 40 Major Depressive Disorder (MDD) patients were studied with a gender distribution of 10 males (25%) and 30 females (75%), age ranging from 21-50 years with the majority (90%) of the participants belonging to Hindu community. Among cases (n=40) Median value of prolactin concentration was 19.7 ng/mL (Z=-2.879,p=0.004) among controls (n=40) Median value of prolactin concentration was 13.6 ng/mL.There was significant positive correlation between HAM-D and serum Prolactin levels. Conclusion: There should be restrictive use of SSRI in hyperprolactinemia in patients suffering from depression.