The endocrine impact of long term risperidone therapy in Asian Indian patients

Open Journal of Psychiatry and Allied Sciences

JP Russell Ravan¹  Naveen Thomas²  Samuel Prasanna³  Thomas Paul⁴  Deepa Ramaswamy⁵  Nihal Thomas⁶ 

[1] Associate Professor and Head of Unit II, Post Graduate of Psychiatry, Kalinga Institute of Medical Science and PBMH, Bhubaneswar, Odisha, India;Consultant Psychiatrist, Melbourne Health, Australia;Department of Biostatistics and Research, CMC Vellore, Tamil Nadu, India;Department of Endocrinology, CMC Vellore, Tamil Nadu, India;Professor and Unit Head, Department of Psychiatry, CMC Vellore, Tamil Nadu, India;Professor of Endocrinology, CMC Vellore, Tamil Nadu, India;

关键词: Antipsychotic;    Hyperprolactinaemia. Bone Mineral Density. Erectile Dysfunction. Menstrual Dysfunction.;    Hyperprolactinaemia;    Bone Mineral Density. Erectile Dysfunction. Menstrual Dysfunction.;    Bone Mineral Density;    Erectile Dysfunction. Menstrual Dysfunction.;    Erectile Dysfunction;    Menstrual Dysfunction.;   

DOI  :  10.5958/2394-2061.2017.00003.9

来源: DOAJ

【 摘 要 】

Background: Risperidone is a widely used antipsychotic, known to cause secondary hyperprolactinaemia. Related problems include bone mineral density (BMD) and vitamin D deficiency. However, there is insufficient information about the extent, severity, and association between these side effects, particularly in the Asian population. Objectives: To estimate the prevalence of osteoporosis, and vitamin D deficiency in patients taking risperidone for more than one year. Also, to investigate whether erectile dysfunction (ED) or menstrual dysfunction (MD) can be used as a proxy indicator of BMD loss in such patients, replacing dual energy X-ray absorptiometry (DEXA) scan. Method: Sixty-five patients (mean age 29.6) receiving risperidone as the only prolactin raising medication for minimum period of one year were selected taking into consideration the socio-demographic and clinical variables. History of ED/ MD, DEXA measurement of their lumbar and hip bone, and endocrine variables were recorded. Results: The prevalence of hyperprolactinaemia in female was found to be 84.4% and in males 78.8%; females being 1.4 times more at risk than males. Abnormal BMD was found in more than 40% of the subjects. Furthermore, 30% had vitamin D deficiency and 60.8% had vitamin D insufficiency. A statistically significant association was observed between ED/ MD and BMD (odds ration [OR] 3.71, confidence interval [CI] 1.23-11.24, p=0.02), but this varied according to the gender. Conclusion: These results suggest that patients on long term risperidone are at high risk of developing hyperprolactinaemia, reduced BMD and Vitamin D, although multiple contributory factors or mechanisms can be suggested. Clinically, ED was more significantly associated with changes in BMD.

【 授权许可】

Unknown