Effects of aripiprazole on prolactin levels and differences in effectiveness in patients with schizophrenia: a post-hoc analysis of the real-world data of a multicenter study

• Published in: Frontiers in psychiatry 2024-08, Vol.15, p.1383173
• Main Authors: Li, Qian, Su, Yun-Ai, Liao, Xuemei, Fang, Maosheng, Gao, Jianliang, Xu, Jia, Duan, Mingjun, Yu, Haiying, Yang, Yang, Chen, Zhiyu, Liu, Jintong, Yan, Shaoxiao, Yao, Peifen, Li, Shuying, Wang, Changhong, Wu, Bin, Zhang, Congpei, Si, Tianmei
• Format: Article
• Language: English
• Subjects: aripiprazole; efficacy; prolactin; Psychiatry; safety; schizophrenia
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2024.1383173

To investigate the effect of aripiprazole on prolactin levels in patients with schizophrenia and analyze whether varying baseline prolactin levels affect the effectiveness and safety of aripiprazole, in a real-life diagnostic and therapeutic setting in a analysis. In this analysis, patients with schizophrenia in the acute phase were divided into an elevated-prolactin group and a normal-prolactin group. After 8 weeks of aripiprazole treatment, changes in the proportion of patients with an abnormal prolactin level were analyzed in both groups, and the efficacy and safety of aripiprazole were compared between the two groups. The elevated-prolactin group had more women, a longer duration of disease, and lower Positive and Negative Syndrome Scale (PANSS) total and subscale scores at baseline compared with the normal-prolactin group (all P < 0.05), and there was no significant difference in the proportion of patients with prior use of antipsychotic medication between the two groups. Regardless of previous antipsychotic use, patients in both groups developed hyperprolactinemia (23/168 [13.7%] in those who had taken antipsychotics vs. 43/375 [11.4%] in those who had not). After 8 weeks of aripiprazole treatment, the proportion of patients with abnormal prolactin in the elevated-prolactin group significantly decreased with prolonged treatment (P < 0.001), and aripiprazole had no significant effect on the normal-prolactin group (P = 0.250). Normal-prolactin group showed better efficacy than the elevated-prolactin group, and the differences in efficacy between the two groups was observed from week 4 to the endpoint (all p