Hyperprolactinemia (Part 2/3): Antidepressants

Q: Patient is 28 year old female with history of breast cancer in remission, presents with recent worsening of depression. Patient reports history of symptomatic hyperprolactinemia after trial of one antidepressant medication in past. 
Which of the following antidepressant has highest likelihood of association with hyperprolactinemia?


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SERTRALINE:

  • Strongest dopamine reuptake blocker among SSRIs.
  • Literature review found highest incidence of SSRI associated hyperprolactinemia for:-

Sertraline > Fuoxetine > Paroxetine > Fluvoxamine

Source: Petit et al. Therapie, 58:159–63.

 


CITALORAM:

  • Literature review found no association.
  • one study found 40% increase basal prolactin level after 10 days of citalopram treatment.

Source: (1) Petit et al. Therapie, 58:159–63.; (2) Clin Neuropharmacol, 20:419–33

 


VENLAFAXINE:

  • Study found no increase in prolactin concentration after two months.

Source: Amsterdam et al, J Affect Disord, 46:151–6.

 


MIRTAZAPINE:

  • Study found no significant increase in prolactin concentration

Source: Laakmann et al, Psychoneuroendocrinology, 24:769–84.

 


BUPROPION:

  • mostly neutral, but may reduce prolactin levels.

Source: Meltzer et al, Adv Biochem Psychopharmacol, 32:303–16.

 


 

Source: Therapeutics and Clinical Risk Management 2007:3(5) 929–951.

 


Post by Dr. Harvinder Singh, M.D.

 

 


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