Adjunctive Aripiprazole Versus Placebo for Antipsychotic-induced Hyperprolactinemia: Meta-analysis of Randomized Controlled Trials

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2013 Aug 13

PMID 23936389

Citations 26

Authors

Xianbin Li

Yilang Tang

Chuanyue Wang

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia.

Methods:

Population: adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms.

Interventions: adjunctive aripiprazole vs. adjunctive placebo.

Outcome Measures: adverse events and efficacy of treatment.

Studies: randomized controlled trials.

Results: Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) -0.05 to 0.04 (95% confidence interval -0.13 to 0.16); I(2) =0% to 68%, P=0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I(2) =43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms.

Conclusion: Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day.

Citing Articles

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Treatment of antipsychotic-induced hyperprolactinemia: an umbrella review of systematic reviews and meta-analyses.

Jiang Q, Li T, Zhao L, Sun Y, Mao Z, Xing Y Front Psychiatry. 2024; 15:1337274.

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