How are high prolactin levels caused by antipsychotics typically treated?

Doctor's Answers 1

The best way is to adjust the antipsychotic regime by either lowering the dose or switching to another antipsychotic (one that has a lower risk of increasing prolactin levels), while maintaining the person's well being and good symptom control.

Sometimes, a combination of two antipsychotics may be needed to achieve good control of the illness while reducing the risk of hyperprolactinemia. It is also important to exclude other possible causes of raised prolactin, such as a prolactinoma, hypothyroidism, chronic liver or kidney disease.

Sometimes the raised prolactin is due to other causes rather than the antipsychotic medication. Treatment then should be focused on treating the actual underlying cause.

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Photo of Dr Beng Yeong Ng

Answered By

Dr Beng Yeong Ng

Psychiatrist

How can amenorrhea due to antipsychotics be treated?

Hi, The best way is to simply adjust the dose or type of antipsychotic. I suggest Confirm that the cause of the hyperprolactemia is due to anti-psychotics and not due to a physical cause such as a prolactinoma, and once confirmed, Clinically assess if the person can still do well with a lower dose of the existing anti-psychotic medication and/or Switching to another antipsychotic that carries a low risk of hyper-propactinemia. E. g. Second-generation antipsychotics (SGAs), especially olanzapine, quetiapine, or even clozapine.

Photo of Dr Terence Leong

Answered By

Dr Terence Leong

Psychiatrist

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