Antipsikotiklere Bağlı Hiperprolaktinemi

Abstract

Sıklıkla hamilelikte meme bezinin büyümesi, laktasyon için süt sentezi ve hazırlanması gibi görevleri ile bilinen prolaktinin günümüzde, bu etkilerinin dışında da pek çok işleve sahip olduğu bilinmektedir. Psikiyatride sıklıkla kullanılan antipsikotikler ve antidepresanlar da hiperprolaktinemi yapabilmektedir. Özellikle tipik antipsikotiklerin ön hipofizdeki D2 reseptörlerini bloke ederek birincil olarak prolaktin seviyelerini yükselttikleri görüşü mevcuttur. Atipik antipsikotiklerin hiperprolaktinemi üzerine etkileri farklılık gösterir. Hiperprolaktinemi; oligomenore, polimenore ve amenore gibi menstrual düzensizliklere ek olarak galaktore, jinekomasti, cinsel işlev bozuklukları (libidoda azalma, uyarılma ve orgazm bozuklukları), infertilite, kadınlarda akne ve hirşutizm, kilo alımı, obezite ve duygudurum değişikliklerine yol açmaktadır. Uzun süreçte hiperprolaktinemi kemik yoğunluğunda azalma ve osteoporoza yol açabilir. Bu makalede psikiyatri hekimlerince sıklıkla kullanılan antipsikotiklerin hiperprolaktinemi yan etkileri ve bu yan etkiler üzerine yapılan araştırmalar gözden geçirilecek, hiperprolaktinemi sonucu gelişen belirtilere yönelik yaklaşımlara değinilecektir.

Keywords

• Antipsikotik ilaçlar, prolaktin, hiperprolaktinemi

Antipsychotic-induced Hyperprolactinemia

Abstract

Prolactin provides the growth of the mammary gland during pregnancy and synthesis and preparation of breast milk for lactation. Antipsychotics and antidepressants that are frequently used in psychiatry, cause hyperprolactinemia. The prevalent opinion is that especially typical antipsychotics increase prolactin levels primarily by blocking D2 receptors in the anterior pituitary. The effects of atypical antipsychotics on hyperprolactinemia vary. Hyperprolactinemia causes galactorrhea, gynecomastia, sexual dysfunction, infertility, acne, hirsutism in women, weight gain, obesity and mood changes in addition to menstrual irregularities such as oligomenorrhea, polymenorrhea and amenorrhea. In the long term, hyperprolactinemia may cause reduction in bone density and osteoporosis. Hyperprolactinemia as a side effect of antipsychotics drugs and its treatment will be reviewed in this article.

Keywords

• Antipsychotic drugs, prolactin, hyperprolactinemia

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