切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2019, Vol. 15 ›› Issue (04) : 472 -475. doi: 10.3877/cma.j.issn.1673-5250.2019.04.020

所属专题: 文献

综述

抗精神病药与高催乳素血症及月经紊乱
游小林1, 谢聪1   
  1. 1. 电子科技大学医学院附属医院·成都市妇女儿童中心医院妇产科 610041
  • 收稿日期:2019-01-10 修回日期:2019-07-16 出版日期:2019-08-01

Hyperprolactinemia and menstrual disorder caused by antipsychotics

Xiaolin You1, Cong Xie1   

  1. 1. Department of Obstetrics and Gynecology, The Affiliated Hospital, School of Medicine, USETC Chengdu Women′s & Children′s Central Hospital, Chengdu 610041, Sichuan Province, China
  • Received:2019-01-10 Revised:2019-07-16 Published:2019-08-01
  • About author:
    Corresponding author: Gan Xiaoqin, Email:
  • Supported by:
    Program of Health and Family Planning Commission of Sichuan Province(17PJ412)
引用本文:

游小林, 谢聪. 抗精神病药与高催乳素血症及月经紊乱[J]. 中华妇幼临床医学杂志(电子版), 2019, 15(04): 472-475.

Xiaolin You, Cong Xie. Hyperprolactinemia and menstrual disorder caused by antipsychotics[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2019, 15(04): 472-475.

抗精神病药(APS)可被分为典型APS和非典型APS。高催乳素血症(HPRL)表现为外周血循环中催乳素水平异常增高。所有典型APS与非典型APS中的利培酮,均可导致女性精神疾病患者血清催乳素水平较正常值显著升高。多数非典型APS仅导致血清催乳素水平短暂、轻微增高,甚至对血清催乳素水平无影响。APS所致HPRL是导致女性精神疾病患者月经紊乱,甚至闭经的主要原因之一。目前针对APS所致HPRL及月经紊乱、闭经治疗的主要措施为降低催乳素水平。不同APS所致HPRL及月经紊乱发生率不同,临床准确评估和管理HPRL,可提高女性精神疾病患者的生活质量及治疗依从性。笔者拟就APS治疗女性精神疾病患者时导致的HPRL与月经紊乱不良反应的处理进行阐述,以期为临床降低该类患者的不良反应提供参考。

Antipsychotics (APS) can be divided into typical and atypical APS. Hyperprolactinemia (HPRL) is characterized by an abnormal increase in prolactin level of peripheral blood circulation. All typical APS and atypical APS risperidone can lead to the serum prolactin level of women with mental illness significantly higher than normal value. While most atypical APS only result in transient and slightly increase of serum prolactin level or even do not lead to the increase of serum prolactin level. HPRL caused by APS is one of the main reasons for menstrual disorders and amenorrhea in women with mental illness. The treatments of HPRL, menstrual disorders and amenorrhea caused by APS are mainly to reduce level of prolactin. The incidences of HPRL and menstrual disorders caused by different APS are different. Accurate clinical evaluation and management of HPRL can improve the quality of life and compliance of female psychiatric patients. This review expounds the treatment of adverse reactions HPRL and menstrual disorders caused by APS in treatment of female psychiatric patients, in order to provide reference for clinical reduction of adverse reactions in female psychiatric patients.

[1]
中华医学会妇产科学分会内分泌学组. 女性高催乳素血症诊治共识[J]. 中华妇产科杂志,2016, 51(3): 161-168.
[2]
Ajmal A,Joffe H, Nachtigall LB. Psychotropic-induced hyperprolactinemia: a clinical review[J]. Psychosomatics, 2014, 55(1): 29-36.
[3]
Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications[J]. World Psychiatry, 2018, 17(3): 341-356.
[4]
González-Blanco L, Greenhalgh AMD, Garcia-Rizo C, et al. Prolactin concentrations in antipsychotic-naïve patients with schizophrenia and related disorders: a Meta-analysis[J]. Schizophr Res, 2016, 174(1-3): 156-160.
[5]
Stubbs B, De Hert M, Sepehry AA, et al. A Meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia[J]. Acta Psychiatr Scand, 2014, 130(6): 470-486.
[6]
Catalá-López F, Suárez-Pinilla M, Suárez-Pinilla P, et al. Inverse and direct cancer comorbidity in people with central nervous system disorders: a Meta-analysis of cancer incidence in 577 013 participants of 50 observational studies[J]. Psychother Psychosom, 2014, 83(2): 89-105.
[7]
周平,刘联琦,郝军锋,等. 阿立哌唑预防女性分裂症患者抗精神病药所致高泌乳素血症的研究[J]. 国际精神病学杂志,2014, 41(2): 68-72.
[8]
邓良华,刘青梅,郑庆梅. 非典型抗精神病药引起女性闭经的调查[J]. 吉林医学,2008, 29(15): 1254-1255.
[9]
Melkersson K. Differences in prolactin elevation and related symptoms of atypical antipsychotics in schizophrenic patients[J]. J Clin Psychiatry, 2005, 66(6): 761-767.
[10]
Bargiota SI, Bonotis KS, Messinis IE, et al. The effects of antipsychotics on prolactin levels and women′s menstruation[J]. Schizophr Res Treatment, 2013, 2013: 502697.
[11]
赵中健,孔德荣,李猛,等. 阿立哌唑、齐拉西酮与利培酮对女性精神分裂症患者雌二醇水平的影响[J]. 精神医学杂志,2015, 28(1): 13-15.
[12]
Chen JX, Su YN, Bian QT, et al. Adjunctive aripiprazole in the treatment of risperidone-induced hyperprolactinemia: a randomized, double-blind, placebo-controlled, dose-response study[J]. Psychoneuroendocrinology, 2015, 58: 130-140.
[13]
Yoon HW, Lee JS, Park SJ, et al. Comparing the effectiveness and safety of the addition of and switching toaripiprazole for resolving antipsychotic-induced hyperprolactinemia: a multicenter, open-label, prospective study[J]. Clin Neuropharmacol, 2016, 39(6): 288-294.
[14]
Bargiota SI, Bonotis K, Messinis IE, et al. Hyperprolactinaemia: psychological aspects and menstrual attitudes of women with schizophrenia[J]. Psychiatry Res, 2015, 226(2-3): 525.
[15]
喻东山,高振忠. 精神科合理用药手册[M]. 南京:江苏科学技术出版社,2005: 65-170.
[16]
Marken PA,Haykal RF, Fisher JN. Management of psychotropic-induced hyperprolactinemia[J]. Clin Pharm, 1992, 11(10): 851-856.
[17]
余云香,吕那,李宇晨,等. 抗精神病药物致高泌乳素血症对女性精神病患者卵巢功能的影响[J]. 中国医药指南,2016, 14(26): 7-8.
[18]
Canuso CM, Goldstein JM,Wojcik J, et al. Antipsychotic medication, prolactin elevation, and ovarian function in women with schizophrenia and schizoaffective disorder[J]. Psychiatry Res, 2002, 111(1): 11-20.
[19]
Chen HZ,Qian MC, Shen XH, et al. Risk factors for medication-induced amenorrhea in first-episode female Chinese patients with schizophrenia treated with risperidone[J]. Shanghai Arch Psychiatry, 2013, 25(1): 40-47.
[20]
Reynolds-May MF,Kenna HA, Marsh W, et al. Evaluation of reproductive function in women treated for bipolar disorder compared to healthy controls[J]. Bipolar Disord, 2014, 16(1): 37-47.
[21]
郑婵燕,周平,李祎鋆,等. 逍遥丸治疗女性精神分裂症患者抗精神病药致高泌乳素血症的对照研究[J]. 实用医学杂志,2015, 31(2): 309-311.
[22]
苏珊娜,刘临兰,杨宇,等. 丹溪治湿痰方治疗抗精神病药物所致闭经临床观察[J]. 深圳中西医结合杂志,2016, 26(16): 48-49.
[1] 马敏榕, 李聪, 周勤. 宫颈癌治疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 497-504.
[2] 林昌盛, 战军, 肖雪. 上皮性卵巢癌患者诊疗中基因检测及分子靶向药物治疗[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 505-510.
[3] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[4] 冉晨曦, 沈如飞, 廖明钰, 廖倩, 周玲, 张玉玲, 隆敏. 垂体瘤孕妇的诊治与围分娩期管理[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 487-491.
[5] 韩春颖, 王婷婷, 李艳艳, 朴金霞. 子宫内膜癌患者淋巴管间隙浸润预测因素研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 403-409.
[6] 陈荟竹, 郭应坤, 汪昕蓉, 宁刚, 陈锡建. 上皮性卵巢癌"二元论模型"的分子生物学研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 394-402.
[7] 周东杰, 蒋敏, 范海瑞, 高玲玲, 孔祥, 卢丹, 王丽萍. 非编码RNA在卵泡发育成熟中作用及其机制的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 387-393.
[8] 刘艳艳, 谭曦, 彭雪. 妊娠合并膀胱低度恶性潜能乳头状尿路上皮肿瘤并文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 212-218.
[9] 魏权, 张燊, 陈慧佳, 邹姮, 胡丽娜. 女性生殖道微生物群与辅助生殖技术相关性研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 151-155.
[10] 胡欧婵, 黄仲英. 不明原因复发性流产患者的治疗研究现状与展望[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 16-22.
[11] 鲍引娣, 范翠芳, 张珺, 孙艳梅, 杨菁. 妊娠合并严重精神障碍精神疾病孕妇妊娠结局的临床分析[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 739-744.
[12] 张晓芳, 王平. 阴道黑色素瘤诊疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 621-626.
[13] 尤琳, 蔡振伟, 乔荆. Turner综合征临床研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 634-639.
[14] 陈雨婷, 杨烨, 谢奇君, 凌秀凤. 女性不孕不育相关疾病患者的生殖道微生物组成异常研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 615-620.
[15] 赵春桃, 梁峰雪, 杨瑞敏, 陈云璇, 陈曦, 焦桂清. 三维盆底超声预测产妇发生盆腔脏器脱垂的价值及影响因素[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 606-614.
阅读次数
全文


摘要