TY - JOUR
T1 - Prolactin and Estrogen Levels in Postmenopausal Women Receiving Aripiprazole Augmentation Treatment for Depression
AU - Rahman, Tahir
AU - Patrick, Cory
AU - Ma, Cynthia
AU - Nicol, Ginger E.
AU - Reynolds, Charles F.
AU - Mulsant, Benoit H.
AU - Hartz, Sarah M.
AU - Yingling, Michael
AU - Lenze, Eric J.
N1 - Funding Information:
The authors have received funding support from the following sources: Siteman Investment Program (The Foundation for Barnes-Jewish Hospital Cancer Frontier Fund; NCI CCSG P30 CA091842; Fashion Footwear Charitable Foundation of New York, Inc; Barnard Trust), Taylor Family Institute for Innovative Psychiatric Research, and Center for Brain Research in Mood Disorders and NIMH award number R25 MH112473. The authors declare no conflicts of interest.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background Antipsychotic drugs are well established to alter serum prolactin levels, often resulting in adverse effects including amenorrhea, galactorrhea, osteoporosis, and loss of libido. There is growing preclinical evidence that prolactin-elevating drugs can instigate the progression of precancerous lesions to breast cancer and that genes activated by prolactin are associated with the development and proliferation of breast cancer. Current guides advise a cautious approach (weighing risks and benefits) to the administration of prolactin-elevating antipsychotic drugs in women with a previously detected breast cancer. Aripiprazole is known to be a prolactin-sparing antipsychotic; however, data regarding its effects on prolactin and estrogens in postmenopausal women are lacking. Methods We examined serum hormone levels in n = 66 women who participated in a randomized, double-blind, placebo-controlled, multicenter trial of aripiprazole (high and low doses) added to an antidepressant in adults older than 60 years. Aripiprazole or placebo tablets were administered for 12 weeks as an augmentation strategy in venlafaxine-treated women. The primary outcomes were the difference in prolactin and estrogen levels. Results There was no significant effect of aripiprazole treatment on prolactin or estrogen levels, including in models that divided groups into low and high doses: prolactin (P = 0.075), estrone (P = 0.67), and estradiol (P = 0.96). Conclusions Aripiprazole addition to an antidepressant did not alter serum estrogens or prolactin. These findings may be relevant in the treatment of some postmenopausal women with depression.
AB - Background Antipsychotic drugs are well established to alter serum prolactin levels, often resulting in adverse effects including amenorrhea, galactorrhea, osteoporosis, and loss of libido. There is growing preclinical evidence that prolactin-elevating drugs can instigate the progression of precancerous lesions to breast cancer and that genes activated by prolactin are associated with the development and proliferation of breast cancer. Current guides advise a cautious approach (weighing risks and benefits) to the administration of prolactin-elevating antipsychotic drugs in women with a previously detected breast cancer. Aripiprazole is known to be a prolactin-sparing antipsychotic; however, data regarding its effects on prolactin and estrogens in postmenopausal women are lacking. Methods We examined serum hormone levels in n = 66 women who participated in a randomized, double-blind, placebo-controlled, multicenter trial of aripiprazole (high and low doses) added to an antidepressant in adults older than 60 years. Aripiprazole or placebo tablets were administered for 12 weeks as an augmentation strategy in venlafaxine-treated women. The primary outcomes were the difference in prolactin and estrogen levels. Results There was no significant effect of aripiprazole treatment on prolactin or estrogen levels, including in models that divided groups into low and high doses: prolactin (P = 0.075), estrone (P = 0.67), and estradiol (P = 0.96). Conclusions Aripiprazole addition to an antidepressant did not alter serum estrogens or prolactin. These findings may be relevant in the treatment of some postmenopausal women with depression.
KW - aripiprazole
KW - breast cancer
KW - estrogen
KW - postmenopausal
KW - prolactin
UR - http://www.scopus.com/inward/record.url?scp=85098924426&partnerID=8YFLogxK
U2 - 10.1097/JCP.0000000000001335
DO - 10.1097/JCP.0000000000001335
M3 - Article
C2 - 33347020
AN - SCOPUS:85098924426
SN - 0271-0749
VL - 41
SP - 31
EP - 35
JO - Journal of Clinical Psychopharmacology
JF - Journal of Clinical Psychopharmacology
IS - 1
ER -