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Hyperprolactinemia, Clinical Considerations, and Infertility in Women on Antipsychotic Medications
Psychopharmacology bulletin
  • Amber N. Edinoff, Louisiana State University Health Science Center
  • Nancy S. Silverblatt, LSU Health Sciences Center - Shreveport
  • Hayley E. Vervaeke, LSU Health Sciences Center - Shreveport
  • Cassidy C. Horton, Louisiana State University
  • Eden Girma, LSU Health Sciences Center - Shreveport
  • Alan David Kaye, Louisiana State University Health Science Center
  • Adam M. Kaye, University of the Pacific
  • Jessica S. Kaye, University of the Pacific
  • Andrew J. Garcia, LSU Health Sciences Center - Shreveport
  • Elisa A. Neuchat, LSU Health Sciences Center - Shreveport
  • Treniece N. Eubanks, LSU Health Sciences Center - Shreveport
  • Giustino Varrassi, LSU Health Sciences Center - Shreveport
  • Omar Viswanath, University of Arizona College of Medicine – Phoenix
  • Ivan Urits, Louisiana State University - Shreveport
ORCiD
Adam M. Kaye: 0000-0002-7224-3322
Document Type
Article
Publication Date
3-16-2021
Abstract

Infertility, the inability to establish a clinical pregnancy after 12 months of regular unprotected sexual intercourse, is caused by a wide variety of both male and female factors. Infertility is estimated to affect between 8-12% of couples trying to conceive globally. Female factor infertility can be subdivided into the following broad categories: ovulatory dysfunction, fallopian tubal disease, uterine causes, and oocyte quality. Hyperprolactinemia causes ovulary dysfunction along with other hormonal abnormalities, such as decreased estrogen, which can lead to infertility. In this regard, antipsychotics are commonly used for both schizophrenia and bipolar disorder. The use of these medications can be associated with hyperprolactinemia and hyperprolactinemia associated infertility. Antipsychotic-induced hyperprolactinemia occurs through blockade of D2 receptors on lactotroph cells of the anterior pituitary gland. Discontinuation of the hyperprolactinemia-inducing antipsychotic is an option, but this may worsen the patient's psychosis or mood. If antipsychotics are determined to be the culprit of infertility, the degree of hyperprolactinemia symptoms, length of treatment with the antipsychotic, and risk of relapse should be assessed prior to discontinuation, reduction, or switching of antipsychotic medications. The treatment of a women's mental health and her desire to have children should always be considered as treatment may influence fertility while on the medication.

Citation Information
Amber N. Edinoff, Nancy S. Silverblatt, Hayley E. Vervaeke, Cassidy C. Horton, et al.. "Hyperprolactinemia, Clinical Considerations, and Infertility in Women on Antipsychotic Medications" Psychopharmacology bulletin Vol. 51 Iss. 2 (2021) p. 131 - 148 ISSN: 2472-2448
Available at: http://works.bepress.com/adam-kaye/144/