Murat BEYAZYUZ, Murat KULOGLU, Cuneyt UNSAL, Yakup ALBAYRAK

Kadın hastalarda risperidon ve paliperidonun serum prolaktin düzeyleri üzerine kısa dönem etkilerinin karşılaştırılması

Amaç: Hiperprolaktinemi antipsikotik kullanımı ile ilişkili bir yan etkidir. Tüm tipik antipsikotiklerin serum prolaktin düzeylerini yükselttiği kabul edilmektedir. Tipik antipsikotiklerle karşılaştırıldığında, atipik antipsikotiklerin serum prolaktin düzeylerini yükseltmeleri açısından daha düşük eğilimleri vardır. Ancak tüm atipik antipsikotiklerin serum prolaktin düzeyi üzerine etkileri her zaman benzer değildir. Bu çalışmada iki benzer atipik antipsikotik olan risperidon ve paliperidonun hiperprolaktinemi ve ilişkili belirtiler açısından kısa dönem etkilerini karşılaştırmayı amaçladık. Yöntem: Bu çalışmada, şizofreni ve diğer psikotik bozuklar ve iki uçlu bozukluk tanıları ile başvuran; risperidon veya paliperidon ile tedavi edilen kadın hastaların bilgileri taranmıştır. Sosyodemografik ve klinik bilgiler açısından yeterli veriye sahip ve tedavi başlangıcında ve 4. haftasında serum prolaktin düzeyleri açısından taranmış hastalar çalışmaya dahil edildi. Sonuçlar: Kırk iki hasta risperidon ile ve 36 hasta paliperidon ile tedavi edilmişti. Gruplar sosyodemografik değişkenler açısından benzerdi. Hem risperidon hem de paliperidon grubunda 4 hafta sonrasında ortalama serum prolaktin düzeyleri anlamlı olarak artmıştı (p<0.001). Risperidon ve paliperidon grubunda menstrual düzensizlikler, galaktore ve cinsel disfonksiyona bağlı olarak ilaç kesilme oranları sırasıyla %11.9 ve %30.6 idi ve bu oran paliperidon grubunda istatiksel olarak fazlaydı (?2=4.13, p=0.04). Tartışma: Paliperidonun faydaları ve risperidona bazı üstünlüklerinin olmasına rağmen, hiperprolaktinemi ve ilişkili belirtiler açısından paliperidonun risperidona göre avantajı olmadığını düşünüyoruz. Ayrıca kadın hastaların paliperidon ile tedavi edildikleri zaman, hiperprolaktinemi ve ilişkili belirtiler açısından düzenli bir şekilde takip edilmesi gerektiğini önermekteyiz. Bilgimize göre, bu çalışma Türkiye’de risperidon ve paliperidonun serum prolaktin düzeyleri üzerine etkilerini karşılaştıran ve gösteren ilk çalışmadır. Paliperidonun serum prolaktin düzeyi üzerine uzun ve kısa dönem etkilerini aydınlatacak daha ileri ve geniş örneklemli çalışmalara ihtiyaç bulunmaktadır.

Anahtar Kelimeler:

risperidon, paliperidon, prolaktin

Comparison of short term effects of risperidone and paliperidone on serum prolactin levels in female patients

Objective: Hyperprolactinemia is an adverse effect, which is related with the use of antipsychotics. All typical antipsychotics are considered to increase serum prolactin levels. Compared with typical antipsychotics, most of the atypical antipsychotics have a reduced tendency for increasing serum prolactin levels. However, effects of all atypical antipsychotics on serum prolactin levels are not always similar. In the present study, we aimed to compare short-term effects of risperidone and paliperidone, which are two similar atypical antipsychotics in terms of hyperprolactinemia and its associated symptoms. Methods: In this study, we screened data of female patients with diagnosis of schizophrenia and other psychotic disorders, bipolar disorder and who were treated with risperidone or paliperidone. The patients who had adequate sociodemographical and clinical data and who had screened in terms of prolactin levels before and fourth week of the treatment were included to study. Results: Forty-two patients have been treated with risperidone and 36 patients have been treated with paliperidone. Treatment groups were similar in terms of sociodemographic variables. The mean values of serum prolactin levels were significantly increased after four weeks of treatment in both groups (p<0.001). The discontinuation rates because of menstrual irregularities, galactorrhea, sexual dysfunction in risperidone and paliperidone groups were 11.9% and 30.6% respectively, and the rate was significantly higher in paliperidone group (?2=4.13, p=0.04). Conclusion: We suggest that beside its benefits and some superiorities compared to risperidone, paliperidone has no advantage over risperidone in terms of hyperprolactinemia and its associated symptoms. We also suggest that female patients should be monitorized regulary in terms of hyperprolactinemia and its associated symptoms while they are being treated with paliperidone. To our knowledge, the present study is the first to compare and demonstrate the effects of paliperidone and risperidone on serum prolactin levels in Turkey. Further studies with larger sample size are needed to highlight the short term and long term effects of paliperidone on serum prolactin levels in female patients.

Keywords:

risperidone, paliperidone, prolactin,

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