Conference paper
HYPERPROLACTINEMIA AND ANTIPSYCHOTIC THERAPY IN SCHIZOPHRENIC PATIENTS WITH HASHIMOTO' S THYROIDITIS
Polina A. Sobolevskaia
; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russia
Leonid P. Churilov
; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russia
Tamara V. Fedotkina
; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russia
Anna Stepochkina
; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russia
Anastasia Dolina
; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russia
Anton N. Gvozdetckii
; City Organizational and Methodological Advisory Department for Psychiatry of the Health Committee & Skvortsov- Stepanov St. Petersburg Psychiatric Hospital No 3, Saint-Petersburg, Russia
Boris V. Andreev †
; P.P. Kaschenko 1st City Mental Hospital, Saint Petersburg, Russia
Yehuda Shoenfeld
; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russia; P. Zabludowicz Centre for Autoimmune Diseases, H. Sheba Medical Center, Tel Hashomer, Israel
Abstract
Introduction: Hyperprolactinemia (HPRL) is known as a side effect of some antidepressants and antipsychotics. These medicines
are common in treatment of schizophrenia. Thus, HPRL is often observed in schizophrenic patients. It is also known that HPRL can
occur in Hashimoto' s thyroiditis due to prolactoliberin effect of thyroliberin. The clinical pathophysiology of the patients with the
comorbodity of schizophrenia and Hashimoto's thyroiditis, receiving antipsychotics, is of special interest.It's fair to assume that
these patients have higher risks of HPRL. To analyze risks of HPRL with antipsychotic treatment, to identify an association between
the antipsychotic therapy (AT) and HPRL in Hashimoto's patiens receiving AT ,to explore the association of HPRL and other
laboratory parameters in patients with Hashimoto's thyroiditis and schizophrenia during AT.
Subjects and methods: We studied 17 patients with HT in comorbidity with schizophrenia receiving AT (mean age 46,5+-12,8
years), all euthyroid or with light hypothyroidism. Different laboratory parameters such as anti-thyroid peroxidase (anti-TPO) and
anti-thyroglobulin (anti-TG) antibodies, blood levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), free
triiodothyronine (FT3) and prolactin (PRL) were analysed.
Results: The study revealed the high levels of PRL, anti-TPO and anti-TG autoantibodies. Thus, patients were classified into 3
groups by the degree of expected HPRL risk from the antipsychotics used: without expected risk, with low and high expected risks.
The correlation analysis detected an inverse significant correlation (R=-0.51; p=0.037) between expected level of drug-associated
HPRL risk and actual PRL levels in studied group. At the same time, we detected a positive significant correlation between the levels
of PRL and FT4 in the groups (R=0.53; p=0.03). The correlations between the levels of PRL and other parameters such as TSH,
FT3, anti-TPO, anti-TG, anti-TSH receptor antibodies were not statistically significant.
Conclusions: HPRL in the group was not associated with taking of antipsychotic drugs with high expected HPRL risk. Yet, a
significant positive correlation existed between the levels of PRL and FT4.Hence, in Hashimoto's thyroiditis accompanied with
treated mental illness there are some non-iatrogenic stimulants of prolactogenesis. It cannot be ruled out that antipsychotics may
interfere with prolactin metabolism, which creates a false effect of a positive correlation between prolactin and free thyroxine levels,
in contrast to common HPRL of hypothyroidism.
Keywords
hyperprolactinemia; antipsychotics; Hashimoto's thyroiditis; thyroid; autoimmunity; schizophrenia; prolactin
Hrčak ID:
274991
URI
Publication date:
19.10.2021.
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