Section - CAP Smart Takes

05. Antipsychotic-Induced Hyperprolactinemia in Youth

Published on March 1, 2023 Certification expiration date: March 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Risperidone, paliperidone, and olanzapine are associated with significant prolactin increases in children and adolescents, whereas aripiprazole was associated with decreased prolactin levels.
Prolatin-related adverse reactions were rare, but the highest frequency was with olanzapine treatment.
When significant hyperprolactinemia is seen, treatment methods, such as dose reduction or switching to a less prolactin-inducing antipsychotic, should be considered.

To unlock this audio you need to become a Silver, Gold, Silver extended or Gold extended Member.

Check Our CME Program

Downloads for Offline Access

Download Audio File (MP3)

Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we will examine antipsychotic-related prolactin changes in children and adolescents, specifically the impact of antipsychotics on prolactin levels and the associated severe adverse reactions. This is critically important because prolactin changes in children and adolescents can expose them to potentially severe adverse reactions related to their growth and pubertal development. So, this is a critical stage of developmental maturation. These authors conducted a meta-analysis where they reviewed 32 randomized, placebo-controlled trials of antipsychotics in over 4,600 adolescents 18 years of age and under, and they looked at prolactin levels and associated adverse reactions. In the studies analyzed, the average duration of these trials was 6 weeks.

Risperidone, paliperidone, and olanzapine were associated with significant prolactin increases; in contrast, aripiprazole was associated with a significant decrease in prolactin. Despite these significant changes in prolactin levels,

Unlock this CAP Smart Take and earn 0.50 CMEs
Become a Silver, Gold, Silver extended or Gold extended Member.

Get Instant Access

Already have an account? Sign in

Learning Objectives:

Recognize that the neuropeptides targeting social impairment in autism spectrum disorder—oxytocin and vasopressin—do not appear to be effective.
Conclude that although depression and anxiety are listed as common side effects in youth treated with ADHD medications, few studies report depression or anxiety as an outcome or side effect.
Acknowledge that ziprasidone use may be associated with less risk for weight gain and metabolic abnormalities, such as diabetes, than other SGAs medications.
Identify the pharmacologic action and potential role of ketamine in treating adolescent depression.
Identify the impact of antipsychotics on prolactin levels in children and adolescents.

Original Release Date: March 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: March 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Lorena Rodriguez, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.