DRUG-INDUCED HYPERPROLACTINEMIA: A NARRATIVE REVIEW

• DOI: https://doi.org/10.22533/at.ed.1595322621015

• Palavras-chave: Drug Use; Hyperprolactinemia; Antipsychotics.

• Keywords: Drug Use; Hyperprolactinemia; Antipsychotics.

• Abstract:

  Introduction: Hyperprolactinemia is characterized by persistently elevated serum prolactin levels and is a common condition in clinical practice. Among non-tumor causes, medication use stands out as one of the main etiologies, especially in patients treated with antipsychotics, prokinetics, and other drugs that interfere with dopaminergic neurotransmission. The condition may be asymptomatic or associated with significant reproductive, sexual, and bone repercussions. Objective: To describe the pathophysiological mechanisms, the main drugs involved, the clinical manifestations, the diagnostic methods, and the therapeutic strategies related to drug-induced hyperprolactinemia. Methodology: This is a narrative review of the literature, based on scientific articles indexed in the PubMed, SciELO, and MEDLINE databases, as well as reference textbooks on endocrinology. Priority was given to publications from the last fifteen years, including clinical studies, systematic reviews, international guidelines, and relevant case reports. Results: Antipsychotics, especially risperidone, paliperidone, amisulpride, and haloperidol, are the drugs most frequently associated with hyperprolactinemia due to the blockade of D2 dopaminergic receptors in pituitary lactotrophs. Other classes involved include prokinetics, antidepressants, H2 antagonists, and opioids. Clinical manifestations vary according to the intensity and duration of the hormonal elevation and may include menstrual disorders, infertility, sexual dysfunction, hypogonadism, and reduced bone mineral density. Diagnosis is based on serum prolactin measurement and careful review of pharmacotherapy, while management prioritizes withdrawal or replacement of the causative medication. Conclusion: Drug-induced hyperprolactinemia is a common and potentially reversible condition. Early recognition and appropriate management are essential to prevent endocrine complications and improve patients' quality of life.