Posted by ed_uk2010 on March 20, 2014, at 4:21:32
In reply to Resperidol May Increase Breast Englargement In Men, posted by Phillipa on March 18, 2014, at 19:41:54
>How come? Phillipa
Risperidone (Risperdal) causes greater elevation of the hormone prolactin than most antipsychotics, but not everyone is affected. Prolactin elevation sometimes causes gynaecomastia. Overall, hyperprolactinaemia is more common in women treated with risperidone than men. Women may experience menstrual disturbances or amenorrhoea and some may start to lactate if prolactin is very high. Both sexes may notice reduced libido. The risk is somewhat dose-dependent. There is a tendency to use lower doses of risperidone than when it was first approved because it is more potent than was first appreciated. In schizophrenia, the usual dose is 2mg to 6mg per day. Side effects are increases at dose above 6mg and efficacy may not be improved.
I don't entirely agree with the 'risperidone can cause gynaecomastia so Rx something else' sentiment in the article. Risperidone works well for some pts. It's one of a number of options available for psychotic disorders. We need a variety of options because pts respond differently.
Olanzapine (Zyprexa) is less likely to elevate prolactin than risperidone but tends to cause more weight gain and metabolic disturbances. Quetiapine (Seroquel) rarely elevates prolactin but it isn't always effective by any means, and many pts discontinue it for this reason... or due to excess drowsiness and dizziness. Aripiprazole (Abilify) actually reduces prolactin but some pts feel nauseated or agitated on it. So, we need options.
Risperidone and paliperidone are also available as depots. Risperidone is given every 2 weeks whereas paliperidone is given every 4 weeks. A lot of people with schizophrenia are too unwell to remember to take tablets, unless they have a lot of social support. Some doctors Rx a small dose of oral Abilify to be taken alongside risperidone/paliperidone depot because it can reduce prolactin back to normal.
poster:ed_uk2010
thread:1062742
URL: http://www.dr-bob.org/babble/20140307/msgs/1062805.html