Novel Approaches in the Treatment of Antipsychotic-Induced Hyperprolactinemia:The Role of Partial Agonists of D2 Dopaminergic Receptors

Abstract

Dopamine is the predominant physiological inhibitory factor of prolactin release. Hyperprolactinemia is associated with potentially serious short and long-term clinical consequences. Several physiological and pathological conditions can cause elevated serum prolactin levels. Of these, in the psychiatric population, antipsychotic drugs are the most common. Because treatment of psychiatric illness often begins during adolescence and involves the long-term administration of these medications, the antipsychotic-induced hyperprolactinemia appears to be a major health concern for these patients. There are many possible management strategies of antipsychotic-induced hyperprolactinemia: estrogen/testosterone replacement, adding a dopamine agonist and introducing an alternative antipsychotic. Aripiprazole, a drug with partial agonist activity at dopamine D2 receptors, may be effective for antipsychotic-induced hyperprolactinemia. This paper reviews recent patents, mechanisms and evidences regarding the clinical action of aripiprazole on antipsychotic-induced hyperprolactinemia. Keywords: Prolactin, hyperprolactinaemia, antipsychotics, aripiprazole, dopamine, partial agonism.