Pharmacopsychiatry 2004; 37(4): 189-191
DOI: 10.1055/s-2004-827176
Letter
© Georg Thieme Verlag KG Stuttgart · New York

Usefulness of Bromocriptine in the Treatment of Amisulpride-induced Hyperprolactinemia

A Case ReportN. Bliesener1 , H. Yokusoglu2 , B. B. Quednow2 , D. Klingmüller1 , K.-U. Kühn2
  • 1Department of Clinical Biochemistry, Division of Endocrinology, University of Bonn, Bonn, Germany
  • 2Department of Psychiatry, Division of Psychopharmacology, University of Bonn, Bonn, Germany
Weitere Informationen

Publikationsverlauf

Received: 27.3.2003 Revised: 28.5.2003

Accepted: 13.6.2003

Publikationsdatum:
01. Juli 2004 (online)

We investigated the effect of bromocriptine on amisulpride-induced endocrinological disturbances (galactorrhea/amenorrhea) and on psychotic symptoms in an open-labeled study. Five women suffering from chronic psychosis and amisulpride-induced hyperprolactinemia (AIH) with amenorrhea and/or galactorrhea received bromocriptine at a dose of 10-40 mg/day. In none of these patients could prolactin levels be reduced to the normal range. They were markedly reduced in three of five patients. Menses recurred in one of four patients with amenorrhea. Lactation decreased in one of three patients with galactorrhea. In two patients with reduced prolactin levels, psychotic symptoms exacerbated but fully remitted after discontinuation of bromocriptine therapy. Thus, bromocriptine seems to annihilate the central effect of amisulpride at a dose that reduces AIH. Therefore, bromocriptine appears not to be suited for the treatment of AIH.

References

  • 1 Arvanitis L A, Miller B G. Multiple fixed doses of ”Seroquel” (quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo. The Seroquel Trial 13 Study Group.  Biol Psychiatry. 1997;  42 233-246
  • 2 Baptista T, Kin N M, Beaulieu S, de Baptista E A. Obesity and related metabolic abnormalities during antipsychotic drug administration: mechanisms, management and research perspectives.  Pharmacopsychiatry. 2002;  35 205-219
  • 3 Beasley CM J r, Tollefson G, Tran P, Satterlee W, Sanger T, Hamilton S. Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial.  Neuropsychopharmacology. 1996;  14 111-123
  • 4 Coulouvrat C, Dondey-Nouvel L. Safety of amisulpride (Solian): a review of 11 clinical studies.  Int Clin Psychopharmacol. 1999;  14 209-218
  • 5 Dickson R A, Glazer W M. Neuroleptic-induced hyperprolactinemia.  Schizophr Res. 1999;  35 Suppl S75-86
  • 6 Dickson R A, Seeman M V, Corenblum B. Hormonal side effects in women: typical versus atypical antipsychotic treatment.  J Clin Psychiatry. 2000;  61 Suppl 3 10-15
  • 7 Kapur S, Langlois X, Vinken P, Megens A A, De Coster R, Andrews J S. The differential effects of atypical antipsychotics on prolactin elevation are explained by their differential blood-brain disposition: a pharmacological analysis in rats.  J Pharmacol Exp Ther. 2002;  302 1129-1134
  • 8 Krupp P, Barnes P. Clozapine-associated agranulocytosis. risk and aetiology.  Br J Psychiatry. 1992;  17 Suppl 38-40
  • 9 Maguire G A. Prolactin elevation with antipsychotic medications: mechanisms of action and clinical consequences.  J Clin Psychiatry. 2002;  63 Suppl 4 56-62
  • 10 Marchese G, Ruiu S, Casti P, Bartholini F, Saba P, Gessa G L, Pani L. Carmoxirole is able to reduce amisulpride-induced hyperprolactinemia without affecting its central effect.  Eur J Pharmacol. 2002;  447 109-114
  • 11 Matsuoka I, Nakai T, Miyake M, Hirai M, Ikawa G. Effects of bromocriptine on neuroleptic-induced amenorrhea, galactorrhea and impotence.  Jpn J Psychiatry Neurol. 1986;  40 639-646
  • 12 Meltzer H Y, Goode D J, Schyve P M, Young M, Fang V S. Effect of clozapine on human serum prolactin levels.  Am J Psychiatry. 1979;  136 1550-1555
  • 13 Miller K K, Klibanski A. Clinical review 106: Amenorrheic bone loss.  J Clin Endocrinol Metab. 1999;  84 1775-1783
  • 14 Smith S. Neuroleptic-associated hyperprolactinemia. Can it be treated with bromocriptine?.  J Reprod Med. 1992;  37 737-740
  • 15 Tollin S R. Use of the dopamine agonists bromocriptine and cabergoline in the management of risperidone-induced hyperprolactinemia in patients with psychotic disorders.  J Endocrinol Invest. 2000;  23 765-770
  • 16 Turrone P, Kapur S, Seeman M V, Flint A J. Elevation of prolactin levels by atypical antipsychotics.  Am J Psychiatry. 2002;  159 133-135
  • 17 Wetzel H, Wiesner J, Hiemke C, Benkert O. Acute antagonism of dopamine D2-like receptors by amisulpride: effects on hormone secretion in healthy volunteers.  J Psychiatr Res. 1994;  28 461-473

Dr. Niclaas Bliesener

Department of Clinical Biochemistry

Division of Endocrinology, University of Bonn

Sigmund Freud Straße 25

53105 Bonn

Telefon: +49-228/287-6513

Fax: +49-228/287-5028

eMail: nbliesener@yahoo.com