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Schizophrenia Research and Treatment
Volume 2018, Article ID 1543034, 9 pages
https://doi.org/10.1155/2018/1543034
Review Article

Change in Prolactin Levels in Pediatric Patients Given Antipsychotics for Schizophrenia and Schizophrenia Spectrum Disorders: A Network Meta-Analysis

1Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
2Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
4Canadian College of Naturopathic Medicine, Toronto, ON, Canada
5Department of Pharmacy, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, ON, Canada
6Department of Psychiatry, Ottawa Hospital, Ottawa, ON, Canada

Correspondence should be addressed to Chakrapani Balijepalli; moc.scimonocehtlaehnoisicerp@illapejilab.inaparkahc

Received 28 August 2017; Accepted 11 February 2018; Published 1 April 2018

Academic Editor: Luis San

Copyright © 2018 Chakrapani Balijepalli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Treatment of schizophrenia with first- and second-generation antipsychotics has been associated with elevated prolactin levels, which may increase the risk for prolactin-related adverse events. Methods. Randomized controlled trials (RCTs) included in a recent systematic review were considered for this analysis. A Bayesian network meta-analysis was used to compare changes in prolactin levels in pediatric patients diagnosed with schizophrenia or schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs). Results. Five RCTs, including 989 patients combined, have evaluated the changes in prolactin for pediatric patients after 6 weeks of treatment with risperidone, quetiapine, aripiprazole, olanzapine, and paliperidone. In the overall study population, treatment with risperidone was associated with the highest increase in mean prolactin levels compared to other SGAs. Patients treated with risperidone 4–6 mg/day were found to experience the greatest increases (55.06 ng/ml [95% CrI: 40.53–69.58]) in prolactin levels, followed by risperidone 1–3 mg/day, paliperidone 3–6 mg/day, and paliperidone 6–12 mg/day. Conclusions. This study shows that there are differences in SGAs ability to cause hyperprolactinemia. Further, there is clear evidence of safety concerns with risperidone and paliperidone treatment in adolescent schizophrenia patients. Registration. PROSPERO CRD42014009506.