Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach

Table 2

Pharmacologic agents affecting prolactin concentrations [21–24].

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Stimulators

Anesthetics, including cocaine

Antipsychotics 1^st generation (chlorpromazine, fluphenazine, haloperidol, loxapine, perphenazine, pimozide, thiothixene, trifluoperazine)

Antipsychotics, 2^nd generation (aripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone)

Phenothiazines

Tricyclic antidepressants (amitriptyline, desipramine, clomipramine, nortriptyline)

Opiates (methadone, morphine, etc.)

Chlordiazepoxide

Amphetamines

Diazepam

Chlorpromazine

SSRIs (citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline)

Other antidepressants (bupropion, venlafaxine, mirtazapine, nefazodone, trazodone)

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Hormones

Estrogen

Oral-steroid contraceptives

Thyrotropin-releasing hormone

Antihypertensives

α-Methyldopa

Reserpine

Verapamil

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Dopamine receptor antagonists

Metoclopramide

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Antiemetics

Sulpiride

Promazine

Perphenazine

Metoclopramide

Domperidone (not available in United States)

Prochlorperazine

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Others

Cimetidine

Cyproheptadine

Protease inhibitors

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Inhibitors

l-Dopa

Dopamine

Bromocriptine

Pergolide

Cabergoline

Depot bromocriptine

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Frequency of increase to abnormal prolactin levels with chronic use: high >50 percent; moderate: 25 to 50 percent; low <25 percent; none or low: case reports. Effect may be dose-dependent.