Serum Prolactin and Macroprolactin Levels among Outpatients with Major Depressive Disorder Following the Administration of Selective Serotonin-Reuptake Inhibitors: A Cross-Sectional Pilot Study

Sollip Kim,Young-Min Park,Lucio Annunziato

doi:10.1371/journal.pone.0082749

Sollip Kim, Young-Min Park + Show 1 more

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https://doi.org/10.1371/journal.pone.0082749

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Journal: PloS one	Publication Date: Dec 2, 2013
Citations: 49	License type: CC BY 3.0

Affiliation: Inje University Ilsan Paik Hospital

Abstract

Clinical trials evaluating the rate of short-term selective serotonin-reuptake inhibitor (SSRI)-induced hyperprolactinemia have produced conflicting results. Thus, the aim of this study was to clarify whether SSRI therapy can induce hyperprolactinemia and macroprolactinemia. Fifty-five patients with major depressive disorder (MDD) were enrolled in this study. Serum prolactin and macroprolactin levels were measured at a single time point (i.e., in a cross-sectional design). All patients had received SSRI monotherapy (escitalopram, paroxetine, or sertraline) for a mean of 14.75 months. Their mean prolactin level was 15.26 ng/ml. The prevalence of patients with hyperprolactinemia was 10.9% for 6/55, while that of patients with macroprolactinemia was 3.6% for 2/55. The mean prolactin levels were 51.36 and 10.84 ng/ml among those with hyperprolactinemia and a normal prolactin level, respectively. The prolactin level and prevalence of hyperprolactinemia did not differ significantly within each SSRI group. Correlation analysis revealed that there was no correlation between the dosage of each SSRI and prolactin level. These findings suggest that SSRI therapy can induce hyperprolactinemia in patients with MDD. Clinicians should measure and monitor serum prolactin levels, even when both SSRIs and antipsychotics are administered.

Highlights

There is evidence that selective serotonin-reuptake inhibitors (SSRIs) can induce hyperprolactinemia, which causes galactorrhea, gynecomastia, hormonal abnormality, and sexual dysfunction [1,2]
Macroprolactinemia is a heterogeneous state with various causes, with 87% of macroprolactin comprising PRL-immunoglobulin G (IgG) complex and 67% being autoantibody-bound PRL [15,16]
Two male and four female patients presented with hyperprolactinemia

Summary

Introduction

There is evidence that selective serotonin-reuptake inhibitors (SSRIs) can induce hyperprolactinemia, which causes galactorrhea, gynecomastia, hormonal abnormality, and sexual dysfunction [1,2]. Even Cohen and Davies reported that SSRIs were most frequent cause of drug-induced hyperprolactinemia [3]. Papakostas and colleagues recently reported that 4.5% of men and 22.2% of women with major depressive disorder (MDD) developed newonset hyperprolactinemia following treatment with fluoxetine [14]. Macroprolactin essentially comprises a complex of PRL with immunoglobulin G (IgG), especially anti-PRL autoantibodies [15]. Macroprolactinemia is a heterogeneous state with various causes, with 87% of macroprolactin comprising PRL-IgG complex and 67% being autoantibody-bound PRL [15,16]. Macroprolactin does not seem to induce hyperprolactinemia-related adverse effects due to its low bioactivity

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