Treatment of antipsychotic-induced hyperprolactinemia: a systematic review of systematic reviews and meta-analyses

Abstract

Abstract Background Hyperprolactinemia is a common antipsychotic-induced adverse event in psychiatric patients, and the quality of clinical studies investigating the best treatments has varied. Thus, to better summarize the clinical evidence, we performed a systematic review of overlapping systematic reviews and meta-analyses for the treatment of antipsychotic-induced hyperprolactinemia. Methods The PubMed, Cochrane Library and Medline databases were searched, and studies meeting our inclusion criteria were selected. Relevant data were extracted, and a systematic review was conducted of all included studies. The quality of included studies was assessed by using PRISMA scores and AMSTAR 2 quality evaluation. Finally, the clinical evidence for appropriate treatments was summarized and discussed. Results Five meta-analyses published between 2013 and 2020 met the requirements for inclusion in this systematic review. The PRISMA scores of the included studies ranged from 19.5–26. AMSTAR 2 quality evaluation showed that 2 of the 5 included studies were of low quality and 3 were of very low quality. The included studies provide clinical evidence that adding aripiprazole or a dopamine agonist can effectively and safely improve antipsychotic-induced hyperprolactinemia. Two studies also showed that adjunctive metformin can reduce serum prolactin level, but more clinical trials are needed to confirm this finding. Conclusion Adjunctive dopamine agonists have been proven to be effective and safe for the treatment of antipsychotic-induced hyperprolactinemia. Among the researched treatments, adding aripiprazole may be the most appropriate.