Amisulpride-induced hyperprolactinaemia is not reversed by addition of aripiprazole

Abstract

Hyperprolactinaemia is a well-recognized neuroendocrine response to antipsychotics (Gründer et al., 1999). Both typical and ‘atypical’ antipsychotics have the potential to elevate serum prolactin levels due to their dopamine D₂ receptor antagonism (Turrone et al., 2002) ‘Atypical’ antipsychotics with higher dopamine D₂ receptor affinities such as risperidone (David et al., 2000) are associated with more pronounced elevation of serum prolactin than those with intermediate or lower affinity such as olanzapine, clozapine, and quetiapine (David et al., 2000). Substituted benzamide antipsychotics such as amisulpride belong to the class of drugs with the strongest potency for prolactin elevation. On the other hand, the partial agonist antipsychotic, aripiprazole, has been shown to lower serum prolactin below placebo levels when it is used as a single agent (Keck et al., 2003).