Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia: meta-analysis of randomized controlled trials
To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia. adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms. adjunctive aripiprazole vs. adju...
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| description | To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia.
adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms.
adjunctive aripiprazole vs. adjunctive placebo.
adverse events and efficacy of treatment.
randomized controlled trials.
Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) -0.05 to 0.04 (95% confidence interval -0.13 to 0.16); I(2) =0% to 68%, P=0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I(2) =43%, P |
| doi_str_mv | 10.1371/journal.pone.0070179 |
| format | Article |
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adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms.
adjunctive aripiprazole vs. adjunctive placebo.
adverse events and efficacy of treatment.
randomized controlled trials.
Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) -0.05 to 0.04 (95% confidence interval -0.13 to 0.16); I(2) =0% to 68%, P=0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I(2) =43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms.
Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0070179</identifier><identifier>PMID: 23936389</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anesthesia ; Antipsychotic Agents - adverse effects ; Antipsychotics ; Archives & records ; Aripiprazole ; Breast cancer ; Care and treatment ; Clinical trials ; Collaboration ; Confidence intervals ; Dopamine ; Dosage and administration ; Drug dosages ; Drug therapy ; Extrapyramidal system ; Fatigue ; Headache ; Health aspects ; Herbal medicine ; Humans ; Hyperprolactinemia ; Hyperprolactinemia - chemically induced ; Hyperprolactinemia - drug therapy ; Insomnia ; Medicine ; Mental disorders ; Meta-analysis ; Patients ; Pharmacology ; Piperazines - adverse effects ; Piperazines - therapeutic use ; Placebos ; Prolactin ; Psychiatry ; Psychosis ; Psychotropic drugs ; Quinolones - adverse effects ; Quinolones - therapeutic use ; Randomization ; Randomized Controlled Trials as Topic ; Risk factors ; Schizophrenia ; Sleep disorders ; Studies ; Treatment Outcome</subject><ispartof>PloS one, 2013-08, Vol.8 (8), p.e70179</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Li et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Li et al 2013 Li et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-b68f17ae188476d6569a4e7e9e865fb636bb369b4ce6b1df52b6a73533396ca23</citedby><cites>FETCH-LOGICAL-c692t-b68f17ae188476d6569a4e7e9e865fb636bb369b4ce6b1df52b6a73533396ca23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731351/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731351/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23936389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xianbin</creatorcontrib><creatorcontrib>Tang, Yilang</creatorcontrib><creatorcontrib>Wang, Chuanyue</creatorcontrib><title>Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia: meta-analysis of randomized controlled trials</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia.
adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms.
adjunctive aripiprazole vs. adjunctive placebo.
adverse events and efficacy of treatment.
randomized controlled trials.
Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) -0.05 to 0.04 (95% confidence interval -0.13 to 0.16); I(2) =0% to 68%, P=0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I(2) =43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms.
Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day.</description><subject>Anesthesia</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotics</subject><subject>Archives & records</subject><subject>Aripiprazole</subject><subject>Breast cancer</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Collaboration</subject><subject>Confidence intervals</subject><subject>Dopamine</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Extrapyramidal system</subject><subject>Fatigue</subject><subject>Headache</subject><subject>Health aspects</subject><subject>Herbal medicine</subject><subject>Humans</subject><subject>Hyperprolactinemia</subject><subject>Hyperprolactinemia - chemically induced</subject><subject>Hyperprolactinemia - drug therapy</subject><subject>Insomnia</subject><subject>Medicine</subject><subject>Mental disorders</subject><subject>Meta-analysis</subject><subject>Patients</subject><subject>Pharmacology</subject><subject>Piperazines - adverse effects</subject><subject>Piperazines - therapeutic use</subject><subject>Placebos</subject><subject>Prolactin</subject><subject>Psychiatry</subject><subject>Psychosis</subject><subject>Psychotropic drugs</subject><subject>Quinolones - adverse effects</subject><subject>Quinolones - therapeutic use</subject><subject>Randomization</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Risk factors</subject><subject>Schizophrenia</subject><subject>Sleep disorders</subject><subject>Studies</subject><subject>Treatment Outcome</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkluL1DAUx4so7rr6DUQLguBDx6Rp08YHYVi8DCwseHsNJ2kyk6Ftukk6OPvoJzfjdJcpKEgeTjj5nX_OLUmeY7TApMJvt3Z0PbSLwfZqgVCFcMUeJOeYkTyjOSIPT-5nyRPvtwiVpKb0cXKWE0Yoqdl58mvZbMdeBrNTKTgzmMHBrW1VulPOjz4dWpBK2FRbl0IfzOD3cmODkZnpm1GqJt3sB-UGZyMYTK86A-_STgXIIGa398anVqcO-sZ25jby0vYh0m28Bmeg9U-TRzoa9WyyF8n3jx--XX7Orq4_rS6XV5mkLA-ZoLXGFShc10VFG1pSBoWqFFM1LbWghApBKBOFVFTgRpe5oFCRkhDCqIScXCQvj7pDaz2f2uc5LgjCtC7RgVgdicbClg_OdOD23ILhfxzWrTm4WHureCE1xDFACRKKUldMCimgIVijRjAQUev99NsoOtVIFauGdiY6f-nNhq_tjpOKYFLiKPBqEnD2ZlQ-_CPliVpDzMr02kYx2Rkv-bKo6qLMSY0itfgLFU8T5xUHorSJ_lnAm1nAYWjqZ1jD6D1fff3y_-z1jzn7-oTdKGjDxtt2DMb2fg4WR1A6671T-r5zGPHD_t91gx_2n0_7H8NenHb9Puhu4clvgtoFNQ</recordid><startdate>20130801</startdate><enddate>20130801</enddate><creator>Li, Xianbin</creator><creator>Tang, Yilang</creator><creator>Wang, Chuanyue</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130801</creationdate><title>Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia: meta-analysis of randomized controlled trials</title><author>Li, Xianbin ; Tang, Yilang ; Wang, Chuanyue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-b68f17ae188476d6569a4e7e9e865fb636bb369b4ce6b1df52b6a73533396ca23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Anesthesia</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotics</topic><topic>Archives & records</topic><topic>Aripiprazole</topic><topic>Breast cancer</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Collaboration</topic><topic>Confidence intervals</topic><topic>Dopamine</topic><topic>Dosage and administration</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>Extrapyramidal system</topic><topic>Fatigue</topic><topic>Headache</topic><topic>Health aspects</topic><topic>Herbal medicine</topic><topic>Humans</topic><topic>Hyperprolactinemia</topic><topic>Hyperprolactinemia - chemically induced</topic><topic>Hyperprolactinemia - drug therapy</topic><topic>Insomnia</topic><topic>Medicine</topic><topic>Mental disorders</topic><topic>Meta-analysis</topic><topic>Patients</topic><topic>Pharmacology</topic><topic>Piperazines - adverse effects</topic><topic>Piperazines - therapeutic use</topic><topic>Placebos</topic><topic>Prolactin</topic><topic>Psychiatry</topic><topic>Psychosis</topic><topic>Psychotropic drugs</topic><topic>Quinolones - adverse effects</topic><topic>Quinolones - therapeutic use</topic><topic>Randomization</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Risk factors</topic><topic>Schizophrenia</topic><topic>Sleep disorders</topic><topic>Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Xianbin</creatorcontrib><creatorcontrib>Tang, Yilang</creatorcontrib><creatorcontrib>Wang, Chuanyue</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xianbin</au><au>Tang, Yilang</au><au>Wang, Chuanyue</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia: meta-analysis of randomized controlled trials</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-08-01</date><risdate>2013</risdate><volume>8</volume><issue>8</issue><spage>e70179</spage><pages>e70179-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia.
adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms.
adjunctive aripiprazole vs. adjunctive placebo.
adverse events and efficacy of treatment.
randomized controlled trials.
Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) -0.05 to 0.04 (95% confidence interval -0.13 to 0.16); I(2) =0% to 68%, P=0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I(2) =43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms.
Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23936389</pmid><doi>10.1371/journal.pone.0070179</doi><tpages>e70179</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia Antipsychotic Agents - adverse effects Antipsychotics Archives & records Aripiprazole Breast cancer Care and treatment Clinical trials Collaboration Confidence intervals Dopamine Dosage and administration Drug dosages Drug therapy Extrapyramidal system Fatigue Headache Health aspects Herbal medicine Humans Hyperprolactinemia Hyperprolactinemia - chemically induced Hyperprolactinemia - drug therapy Insomnia Medicine Mental disorders Meta-analysis Patients Pharmacology Piperazines - adverse effects Piperazines - therapeutic use Placebos Prolactin Psychiatry Psychosis Psychotropic drugs Quinolones - adverse effects Quinolones - therapeutic use Randomization Randomized Controlled Trials as Topic Risk factors Schizophrenia Sleep disorders Studies Treatment Outcome |
| title | Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia: meta-analysis of randomized controlled trials |
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