Hiperprolactinemia y tratamiento antipsicótico. Manifestaciones clínicas y manejo

Hyperprolactinemia (HPRL) has until recently been considered an unavoidable side effect inherent to antipsychotic treatment, and has probably been the reason why its clinical effects are underestimated in daily clinical practice. In this review we evaluate the different prolactin raising potential of the antipsychotic (AP) drugs, as well as the clinical and individual situations where special precautions must be taken when using these medications. The most common and better known clinical consequences of HPRL-induced by APs are sexual and reproductive symptoms, with different characteristics depending on gender, but recently more evidence has also been provided on an involvement in bone mineral density, carcinogenesis and the cardiovascular system. Though these effects still require more evidence, they are important to be taken into account when prescribing APs drugs in susceptible patients. It is essential to prevent and minimize the effect of HPRL-induced by APs and, once established, to consider its severity and clinical effects, and to provide a proper management, treatment and the involvement of other disciplines.