Changes in Hyperprolactinemia Secondary to Antipsychotics After Switching to Quetiapine
Condition: APS-related Hyperprolactinaemia; Schizophrenia; Bipolar Disorder
MeSH terms: Hyperprolactinemia; Schizophrenia; Bipolar Disorder
Study type: Observational

Summary: 
      Hyperprolactinaemia is a common side effect of some antipsychotics (APS), including some
      atypicals. Clinical consequences of hyperprolactinaemia are broad including amenorrhea,
      galactorrhea, tender breasts, gynecomastia and sexual dysfunction. Less known but also
      present is the increased cardiovascular risk, specially in women, disorders of osteoporotic
      type and a potential increased risk of breast and prostate cancer.

      Despite this growing evidence, there are no consistent published data in order to adopt
      evidence-based decisions that may be beneficial for the patient.

      This naturalistic observational 6 months follow-up study on patients with APS-induced
      hyperprolactinemia aims to obtain more information about the switching approach in cases of
      hyperprolactinemia secondary to APS and to better establish the role of switching to
      quetiapine (APS not related with the increase prolactin levels) in this problem.
    

Detailed description: 
      Hyperprolactinaemia is a common side effect of some antipsychotics (APS), including some
      atypicals. Clinical consequences of hyperprolactinaemia include most remarkably the
      appearance of amenorrhea, galactorrhea, tender breasts, and gynecomastia - associated with
      dysmorphophobia and psychological disorders in some cases, particularly in men-. Another
      common side effect is sexual dysfunction, with decreased libido, anorgasmia, and in men,
      impotence, reduced volume ejaculated and even backward ejaculation. Less known but also
      present is the increased cardiovascular risk, specially in women, disorders of osteoporotic
      type. Furthermore, several authors have related hyperprolactinemic states with the
      development of breast cancer including a potential worse prognosis of it (Mandala, 1999;
      Clevenger 2003; Mujagic, 2004), and with the development of metastatic prostate cancer and
      resistance to hormone therapy in men (Lisonni, 2005)

      Despite this growing evidence and the fact that APS with no apparent increase of prolactin
      levels exist, such as quetiapine or aripiprazole, many clinicians don't even monitor
      prolactin levels in patients following APS treatment. And when they do, they find there are
      no consistent published data in order to adopt evidence-based decisions that may be
      beneficial for the patient.

      This naturalistic observational 6 months follow-up study on patients with APS-induced
      hyperprolactinemia aims to obtain more information about the switching approach in cases of
      hyperprolactinemia secondary to APS and to better establish the role of switching to
      quetiapine in this problem.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Adult patients diagnosed with schizophrenia or bipolar disorder who developed APS-related
        hyperprolactinaemia and were switched to quetiapine based on the clinician's judgement
      
Keywords: APS-related hyperprolactinaemia; Quetiapine; Schizophrenia; Bipolar