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催乳素升高是抗精神病药物常见的不良反应,临床表现为男性乳房女性化、女性乳房胀痛、溢乳、月经失调症状、性功能障碍、骨质疏松及代谢障碍等,发生率为25%～89%。抗精神病药物所致高催乳素血症(HPRL)的发生与性别、年龄、药物种类及剂量等相关。发病机制可能是抗精神病药物阻断垂体前叶D2受体而减弱多巴胺抑制泌乳素细胞分泌的作用,导致催乳素水平升高。抗精神病药物所致HPRL须与严重应激或抑郁状态、妊娠、甲状腺功能减退症、肾衰竭、垂体肿瘤及卵巢病变等进行鉴别诊断。抗精神病药物所致HPRL的治疗包括停用致病药物,降低药物剂量,换用致HPRL风险较低的药物,也可给予多巴胺受体激动剂、中药或低频重复经颅磁刺激。
Prolactin increased antipsychotic common adverse reactions, clinical manifestations of male feminization of the female, breast pain, galactorrhea, symptoms of menstrual disorders, sexual dysfunction, osteoporosis and metabolic disorders, the incidence was 25% ~ 89%. Antipsychotic-induced hyperprolactinemia (HPRL) occurs according to gender, age, type of drug and dose. The pathogenesis may be that antipsychotics block the D2 receptor in the anterior pituitary and weaken the action of dopamine in inhibiting the secretion of prolactin cells, resulting in elevated prolactin levels. HPRL caused by antipsychotics should be differentially diagnosed with severe stress or depression, pregnancy, hypothyroidism, renal failure, pituitary tumors and ovarian lesions. Treatment of HPRL with antipsychotics includes the discontinuation of pathogenic drugs, the reduction of drug doses, the switch to less risky HPRL drugs, dopamine receptor agonists, traditional Chinese medicines or repeated low-frequency transcranial magnetic stimulation.