The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia

Stacy R. David, Cindy C. Taylor, Bruce J. Kinon, Alan Breier

Research output: Contribution to journalArticle

199 Citations (Scopus)

Abstract

Background: There is relatively little comparative information on elevations in plasma prolactin level (PRL) with conventional versus novel antipsychotic agents. Objective: This paper examines the comparative effects on PRL of olanzapine, risperidone, and haloperidol based on data from 3 multicenter, double-blind, randomized clinical trials. Magnitude of response, dose dependency, time course, effects of sex and age, and response to switching from haloperidol to olanzapine are assessed. Methods: The effects of olanzapine, risperidone, and haloperidol on PRL were assessed in patients with schizophrenia or related psychoses participating in 3 double-blind clinical trials: (1) a 6-week acute trial comparing olanzapine 5 to 20 mg/d (n = 1336) and haloperidol 5 to 20 mg/d (n = 660), with a 1-year, open-label olanzapine extension for responders; (2) a 54-week study comparing olanzapine 5 to 20 mg/d (n = 21), risperidone 4 to 10 mg/d (n = 21), and haloperidol 5 to 20 mg/d (n = 23) in early illness; and (3) a 28-week study comparing olanzapine 10 to 20 mg/d (n = 172) and risperidone 4 to 12 mg/d (n = 167). Results: PRL elevations were significantly greater with risperidone than with either olanzapine or haloperidol in study 2, and significantly greater than with olanzapine in study 3 (all, P <0.001). PRL elevations were significantly greater with haloperidol than with olanzapine in study 1 (P <0.001). A dose-response relationship was not consistently confirmed with any of the drug treatments. Risperidone-associated PRL elevations peaked relatively early in treatment. In haloperidol- and risperidone-treated patients, the mean change in PRL was greater in women than in men. PRL decreased significantly when treatment was switched from haloperidol to olanzapine. Conclusions: This side-by-side analysis of 3 independent studies suggests that with the 3 antipsychotic drugs studied, PRL is elevated moderately by olanzapine (mean change, 1-4 ng/mL), intermediately by haloperidol (mean change, ≃17 ng/mL), and strongly by risperidone (mean change, 45-80 ng/mL). No consistent dose-response relationship was observed, and the time course and sex-dependency of the response differed between the 3 agents. Patients with haloperidol-induced hyperprolactinemia may benefit from a switch to olanzapine. Long-term studies examining the health consequences of chronic hyperprolactinemia during antipsychotic treatment are needed.

Original languageEnglish (US)
Pages (from-to)1085-1096
Number of pages12
JournalClinical Therapeutics
Volume22
Issue number9
DOIs
StatePublished - 2000

Fingerprint

olanzapine
Risperidone
Haloperidol
Prolactin
Schizophrenia
Antipsychotic Agents
Hyperprolactinemia

Keywords

  • Atypical antipsychotic agents
  • Haloperidol
  • Olanzapine
  • Prolactin
  • Risperidone

ASJC Scopus subject areas

  • Pharmacology

Cite this

The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. / David, Stacy R.; Taylor, Cindy C.; Kinon, Bruce J.; Breier, Alan.

In: Clinical Therapeutics, Vol. 22, No. 9, 2000, p. 1085-1096.

Research output: Contribution to journalArticle

David, Stacy R. ; Taylor, Cindy C. ; Kinon, Bruce J. ; Breier, Alan. / The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. In: Clinical Therapeutics. 2000 ; Vol. 22, No. 9. pp. 1085-1096.
@article{2864247659a34f02afd94f8daa280b44,
title = "The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia",
abstract = "Background: There is relatively little comparative information on elevations in plasma prolactin level (PRL) with conventional versus novel antipsychotic agents. Objective: This paper examines the comparative effects on PRL of olanzapine, risperidone, and haloperidol based on data from 3 multicenter, double-blind, randomized clinical trials. Magnitude of response, dose dependency, time course, effects of sex and age, and response to switching from haloperidol to olanzapine are assessed. Methods: The effects of olanzapine, risperidone, and haloperidol on PRL were assessed in patients with schizophrenia or related psychoses participating in 3 double-blind clinical trials: (1) a 6-week acute trial comparing olanzapine 5 to 20 mg/d (n = 1336) and haloperidol 5 to 20 mg/d (n = 660), with a 1-year, open-label olanzapine extension for responders; (2) a 54-week study comparing olanzapine 5 to 20 mg/d (n = 21), risperidone 4 to 10 mg/d (n = 21), and haloperidol 5 to 20 mg/d (n = 23) in early illness; and (3) a 28-week study comparing olanzapine 10 to 20 mg/d (n = 172) and risperidone 4 to 12 mg/d (n = 167). Results: PRL elevations were significantly greater with risperidone than with either olanzapine or haloperidol in study 2, and significantly greater than with olanzapine in study 3 (all, P <0.001). PRL elevations were significantly greater with haloperidol than with olanzapine in study 1 (P <0.001). A dose-response relationship was not consistently confirmed with any of the drug treatments. Risperidone-associated PRL elevations peaked relatively early in treatment. In haloperidol- and risperidone-treated patients, the mean change in PRL was greater in women than in men. PRL decreased significantly when treatment was switched from haloperidol to olanzapine. Conclusions: This side-by-side analysis of 3 independent studies suggests that with the 3 antipsychotic drugs studied, PRL is elevated moderately by olanzapine (mean change, 1-4 ng/mL), intermediately by haloperidol (mean change, ≃17 ng/mL), and strongly by risperidone (mean change, 45-80 ng/mL). No consistent dose-response relationship was observed, and the time course and sex-dependency of the response differed between the 3 agents. Patients with haloperidol-induced hyperprolactinemia may benefit from a switch to olanzapine. Long-term studies examining the health consequences of chronic hyperprolactinemia during antipsychotic treatment are needed.",
keywords = "Atypical antipsychotic agents, Haloperidol, Olanzapine, Prolactin, Risperidone",
author = "David, {Stacy R.} and Taylor, {Cindy C.} and Kinon, {Bruce J.} and Alan Breier",
year = "2000",
doi = "10.1016/S0149-2918(00)80086-7",
language = "English (US)",
volume = "22",
pages = "1085--1096",
journal = "Clinical Therapeutics",
issn = "0149-2918",
publisher = "Excerpta Medica",
number = "9",

}

TY - JOUR

T1 - The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia

AU - David, Stacy R.

AU - Taylor, Cindy C.

AU - Kinon, Bruce J.

AU - Breier, Alan

PY - 2000

Y1 - 2000

N2 - Background: There is relatively little comparative information on elevations in plasma prolactin level (PRL) with conventional versus novel antipsychotic agents. Objective: This paper examines the comparative effects on PRL of olanzapine, risperidone, and haloperidol based on data from 3 multicenter, double-blind, randomized clinical trials. Magnitude of response, dose dependency, time course, effects of sex and age, and response to switching from haloperidol to olanzapine are assessed. Methods: The effects of olanzapine, risperidone, and haloperidol on PRL were assessed in patients with schizophrenia or related psychoses participating in 3 double-blind clinical trials: (1) a 6-week acute trial comparing olanzapine 5 to 20 mg/d (n = 1336) and haloperidol 5 to 20 mg/d (n = 660), with a 1-year, open-label olanzapine extension for responders; (2) a 54-week study comparing olanzapine 5 to 20 mg/d (n = 21), risperidone 4 to 10 mg/d (n = 21), and haloperidol 5 to 20 mg/d (n = 23) in early illness; and (3) a 28-week study comparing olanzapine 10 to 20 mg/d (n = 172) and risperidone 4 to 12 mg/d (n = 167). Results: PRL elevations were significantly greater with risperidone than with either olanzapine or haloperidol in study 2, and significantly greater than with olanzapine in study 3 (all, P <0.001). PRL elevations were significantly greater with haloperidol than with olanzapine in study 1 (P <0.001). A dose-response relationship was not consistently confirmed with any of the drug treatments. Risperidone-associated PRL elevations peaked relatively early in treatment. In haloperidol- and risperidone-treated patients, the mean change in PRL was greater in women than in men. PRL decreased significantly when treatment was switched from haloperidol to olanzapine. Conclusions: This side-by-side analysis of 3 independent studies suggests that with the 3 antipsychotic drugs studied, PRL is elevated moderately by olanzapine (mean change, 1-4 ng/mL), intermediately by haloperidol (mean change, ≃17 ng/mL), and strongly by risperidone (mean change, 45-80 ng/mL). No consistent dose-response relationship was observed, and the time course and sex-dependency of the response differed between the 3 agents. Patients with haloperidol-induced hyperprolactinemia may benefit from a switch to olanzapine. Long-term studies examining the health consequences of chronic hyperprolactinemia during antipsychotic treatment are needed.

AB - Background: There is relatively little comparative information on elevations in plasma prolactin level (PRL) with conventional versus novel antipsychotic agents. Objective: This paper examines the comparative effects on PRL of olanzapine, risperidone, and haloperidol based on data from 3 multicenter, double-blind, randomized clinical trials. Magnitude of response, dose dependency, time course, effects of sex and age, and response to switching from haloperidol to olanzapine are assessed. Methods: The effects of olanzapine, risperidone, and haloperidol on PRL were assessed in patients with schizophrenia or related psychoses participating in 3 double-blind clinical trials: (1) a 6-week acute trial comparing olanzapine 5 to 20 mg/d (n = 1336) and haloperidol 5 to 20 mg/d (n = 660), with a 1-year, open-label olanzapine extension for responders; (2) a 54-week study comparing olanzapine 5 to 20 mg/d (n = 21), risperidone 4 to 10 mg/d (n = 21), and haloperidol 5 to 20 mg/d (n = 23) in early illness; and (3) a 28-week study comparing olanzapine 10 to 20 mg/d (n = 172) and risperidone 4 to 12 mg/d (n = 167). Results: PRL elevations were significantly greater with risperidone than with either olanzapine or haloperidol in study 2, and significantly greater than with olanzapine in study 3 (all, P <0.001). PRL elevations were significantly greater with haloperidol than with olanzapine in study 1 (P <0.001). A dose-response relationship was not consistently confirmed with any of the drug treatments. Risperidone-associated PRL elevations peaked relatively early in treatment. In haloperidol- and risperidone-treated patients, the mean change in PRL was greater in women than in men. PRL decreased significantly when treatment was switched from haloperidol to olanzapine. Conclusions: This side-by-side analysis of 3 independent studies suggests that with the 3 antipsychotic drugs studied, PRL is elevated moderately by olanzapine (mean change, 1-4 ng/mL), intermediately by haloperidol (mean change, ≃17 ng/mL), and strongly by risperidone (mean change, 45-80 ng/mL). No consistent dose-response relationship was observed, and the time course and sex-dependency of the response differed between the 3 agents. Patients with haloperidol-induced hyperprolactinemia may benefit from a switch to olanzapine. Long-term studies examining the health consequences of chronic hyperprolactinemia during antipsychotic treatment are needed.

KW - Atypical antipsychotic agents

KW - Haloperidol

KW - Olanzapine

KW - Prolactin

KW - Risperidone

UR - http://www.scopus.com/inward/record.url?scp=0033815409&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033815409&partnerID=8YFLogxK

U2 - 10.1016/S0149-2918(00)80086-7

DO - 10.1016/S0149-2918(00)80086-7

M3 - Article

VL - 22

SP - 1085

EP - 1096

JO - Clinical Therapeutics

JF - Clinical Therapeutics

SN - 0149-2918

IS - 9

ER -