Prolactin, Hyperprolactinaemia, First episode psychosis (FEP) Schizophrenia, Antipsychotics, Stress.
This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPACT Programme (Grant Reference Number RP-PG-0606-1049) and supported by the UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust; The Institute of Psychiatry, Psychology & Neuroscience at Kings College London. FG is in part funded by the Stanley Medical Research Institute and FG and BS by the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care Funding scheme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
Little is known about hyperprolactinaemia (HPL) in first episode psychosis (FEP) patients. We investigated longitudinal changes in serum prolactin in FEP, and the relationship between HPL, and antipsychotic medication and stress.
Serum prolactin was recorded in FEP patients at recruitment and again, 3 and 12 months later. HPL was defined as a serum prolactin level > 410 mIU/L (~ 19.3 ng/ml) for males, and a serum prolactin level > 510 mIU/L (~ 24.1 ng/ml) for females.
From a total of 174 people with serum prolactin measurements at study recruitment, 43% (n = 74) had HPL, whilst 27% (n = 21/78) and 27% (n = 26/95) had HPL at 3 and 12 months respectively. We observed higher serum prolactin levels in females versus males (p < 0.001), and in antipsychotic treated (n = 68) versus antipsychotic naïve patients (p < 0.0001). Prolactin levels were consistently raised in FEP patients taking risperidone, amisulpride and FGAs compared to other antipsychotics. No significant relationship was observed between perceived stress scores (β = 7.13, t = 0.21, df = 11, p = 0.0.84 95% CI − 72.91–87.16), or objective life stressors (β = − 21.74, t = − 0.31, df = 8, p = 0.77 95% CI − 218.57–175.09) and serum prolactin.
Our study found elevated rates of HPL over the course of the first 12 months of illness. We found no evidence to support the notion that stress is related to elevated serum prolactin at the onset of psychosis.
Medicine and Health Sciences | Psychiatry and Psychology
Lally J, Ajnakina O, Stubbs B, Williams HR, Colizzi M, Carra E, Fraietta S, Gardner-Sood P, Greenwood KE, Atakan Z, Mondelli V, Ismail K, Howes O, Taylor DM, Smith S, Hopkins D, Murray RM, Gaughran F. Hyperprolactinaemia in first episode psychosis - A longitudinal assessment. Schizophrenia Research. 2017;189:117-125.
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