Quetiapine의 장기투여에 따른 혈중 Estradiol과 Prolactin 농도 변화의 추적관찰 2례

Abstract

Antipsychotic-induced hyperprolactinemia can cause amenorrhea, irregular menses, gynecomastia, galactorrhea, sexual dysfunction, anovulation as well as hypoestrogenemia. For resolution strategies of theses undesirable side effects, reducing the dosage of antipsychotics, treating with a prolactin-lowering agents, or switching to prolactin-sparing antipsychotics could be suggested. It have been reported that atypical antipsychotics such as clozapine, quetiapine, and olanzapine would increase prolactin secretion transiently and mildly or would not at all. However, few long-term follow-up studies about hormonal changes with these drugs have yield limitations. We made long term prospective observation on the change in serum levels of estrogen and prolactin after switching to quetiapine. After switching from risperidone to quetiapine, they resumed normal menstruation, and their serum prolactin levels fell into the normal range. During the long term quetiapine treatment, serum prolactin level was sustained within normal range. However, serum estrogen level was decreased at follicular phases in one case. These results suggested that long term quetiapine treatment might not affect prolactin and influence on estrogen in some female patient and further investigations should be needed to evaluate the effect of the prolactin sparing antipsychotic agents on gonadal hormones.