Abstract
Introduction: Hyperprolactinemia is a common side effect associated with the use of anti-psychotic medications. This study aimed at exploring the rate of hyperprolactinemia induced by anti-psychotic drugs in adult patients admitted to Sultan Qaboos University Hospital (SQUH) and Al Masarra hospital (AMH). Additionally, factors associated with higher prolactin levels in anti-psychotic patients were explored.Methods: Bespoke XL sheets on age, gender, region (place of stay), BMI, diagnosis, type of drugs, dose, symptoms, and prolactin levels were recorded from the existing health information system. All adult patients who were on anti-psychotic medication between January 2016 and June 2019 were included. Patients diagnosed with pre-existing endocrine conditions, pregnant females, and those with high prolactin levels at baseline were excluded.Results: A total of 1103 cases were included in this study of which 34.1% were from the SQUH vs 65.9% from AMH. The mean (SD) age of the study population was 35.6 (12.1), 56.7% were females and 58.7% cases were from Muscat. The common diagnoses were schizophrenia (59.3%) and bipolar affective disorder (14.7%). High prolactin levels existed in 68.3% of the cases from which 59.6% were treated with atypical anti-psychotic drugs. The proportion of cases with high prolactin levels in AMH was significantly different (higher) compared to cases in SQUH (76.9% vs 51.6%, P<0.001).The most common symptoms were painful breasts (55.2%), galactorrhoea (10.5%), amenorrhea (14.3%) and irregular periods (20.0%). Type of drugs used [haloperidol (typical) vs risperidone (atypical) anti-psychotics (P<0.001)], older vs younger age (P=0.03), and presence vs absence of symptoms (P<0.001) were predictors for the high prolactin levels.Conclusion: Similar to evidence from the west, results from this study showed a high rate of hyperprolactinemia in adults treated with anti-psychotics. More work is required to standardize anti-psychotic management and monitoring guidelines for psychotic patients across all psychiatric hospitals in Oman.
Highlights
Hyperprolactinemia is a common side effect associated with the use of anti-psychotic medications
High prolactin levels existed in 68.3% of the cases from which 59.6% were treated with atypical antipsychotic drugs
The proportion of cases with high prolactin levels in Al Masarra hospital (AMH) was significantly different compared to cases in Sultan Qaboos University Hospital (SQUH) (76.9% vs 51.6%, P
Summary
Hyperprolactinemia is a common side effect associated with the use of anti-psychotic medications. Factors associated with higher prolactin levels in anti-psychotic patients were explored. The elevated level of prolactin has been observed in many neurological, medical, and psychiatric disorders. It is often asymptomatic and might sometimes be associated with a wide variety of side effects. Hyperprolactinemia has been reported as a common side effect after use of anti-psychotic medications in patients with psychiatric disease [2,3]. According to a review in 2018, it is estimated that 792 million people in 2017 lived with a mental health disorder This is slightly more than one in 10 people globally (10.7%) [4]. The new secondgeneration or atypical anti-psychotics include olanzapine, risperidone, quetiapine, and paliperidone [5]
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