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Meta-Analysis
. 2023;21(6):1319-1328.
doi: 10.2174/1570159X21666221027143920.

Sex Differences in Serum Prolactin Levels in Children and Adolescents on Antipsychotics: A Systematic Review and Meta-Analysis

Lidia Ilzarbe  1   2 , Daniel Ilzarbe  3   2   4 , Felipe Gutiérrez-Arango  1 , Inmaculada Baeza  3   2   4
Affiliations
Meta-Analysis

Sex Differences in Serum Prolactin Levels in Children and Adolescents on Antipsychotics: A Systematic Review and Meta-Analysis

Lidia Ilzarbe et al. Curr Neuropharmacol. 2023.

Abstract

Background: Serum prolactin levels are influenced by sex, physical development and medications among other factors. Antipsychotics usually increase serum prolactin levels in both adults and younger patients, but no study has reviewed the potential association between sex and vulnerability for developing hyperprolactinemia among children and adolescents.

Objective: Systematic review and meta-analysis of serum prolactin levels in children and adolescents on antipsychotic treatment for any psychiatric diagnosis to determine the effect of sex.

Methods: A systematic search was performed in MEDLINE/PubMed/Web of Science and Cochrane databases for randomized controlled trials of antipsychotics in children and adolescents reporting serum prolactin levels by sex.

Results: Of 1278 identified records, seven studies were included, comparing different single antipsychotics to placebo (risperidone N=4; lurasidone N=1; olanzapine N=1; queriapine N=1). Both male and female children and adolescents on antipsychotics presented a significant increase in prolactin levels relative to subjects receiving a placebo. (Male: 16.53 with 95% CI: 6.15-26.92; Female: 26.97 with 95% CI: 9.18-44.75). The four studies using risperidone had similar findings (Male: 26.49 with 95% CI: 17.55-35.43; Female: 37.72 with 95% CI: 9.41-66.03). In the direct comparison between sexes, females showed greater increases in prolactin, but the differences were not statistically significant.

Conclusion: Serum prolactin levels are increased in children and adolescents of both sexes on antipsychotics, with females showing a slightly greater increase than males. Further research is needed to clarify the influence of sex and pubertal status on prolactin levels in children and adolescents taking antipsychotics.

Keywords: Children; adolescent; antipsychotic; meta-analysis; prolactin; sex.

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Conflict of interest statement

LI has received medical education support from Otsuka-Lundbeck and training courses support from Otsuka-Lundbeck and Janssen. DI has received funding from the Spanish Ministry of Science, Innovation and Universities, Instituto de Salud Carlos III, ‘Rio Hortega’ contract CM17/00019, with the support of European Social Fund; and continuing medical education support from Rubió and Angelini. FG-A has received medical education support from Viatris and training courses support from Otsuka-Lundbeck and Janssen. IB has received honoraria and travel support from Angelini, Otsuka-Lundbeck and Janssen, as well as research support from the Fundación Alicia Koplowitz and grants from the Spanish Ministry of Health, Instituto de Salud Carlos III (F.I.S.-PI18/0242, INT19/00021).

Figures

Fig. (1)
Fig. (1)
PRISMA flowchart is reporting the search strategy of the meta-analysis [19].
Fig. (2)
Fig. (2)
Forest plot of randomized control trials of all antipsychotics prescribed to children and adolescents evaluating prolactin changes by sex, in males (A) and females (B); and of randomized control trials of risperidone prescribed to children and adolescents evaluating prolactin changes by sex, in males (C) and females (D) relative to placebo.
See this image and copyright information in PMC

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