engleski

Determination of prolactin levels in psychiatric patients –real challenge?

BACKGROUND-AIM: Blood sampling for determination of prolactin levels in psychiatric patients is challenging job. For fulfilling preanalitical requirements it has to pay attention for patient’s preparation and psychiatric therapy. In our study we wanted to investigate association of stress, type of psychiatric therapy and stage of psychiatric disorder with prolactin levels. METHODS: 22 patients (16 women, 6 men) were admitted to Psychiatric Hospital ‘Sveti Ivan’ with psychotic disorders (F20-F29). The mean age was 32, 64 with range of 18-55 years. Patient data of psychopharamcotherapy (risperidone, clozapine, olanzapine) and questionnaires scales: DASS21-stress symptoms and PANSS-stage of disease were collected. Blood samples were taken in the morning after 30 min rest. Prolactin, prolactin after precipitation with PEG 6000 and cortisol were measured using clia assay on Beckmann Coulter Access. Statistical analysis was performed with Mann Whitney U test and correlation analysis with Pearson’s and Spearman’s coefficients using SPSS software and p≤0.05 was considered as statically significant. RESULTS: Our results showed that 16/22 patients had hyperprolactinemia (mean 1100 mIU/L range=121-3702) and after PEG precipitation prolactin recovery was<40% (mean=8, 62 % range=2, 77-33, 72). Cortisol levels were: mean 336 nmol/L range=181, 61-457, 04). There is a significant correlation between PANSS scale (expressed positive, rho=0, 511 p=0, 015 or negative symptoms, rho=0, 486 p=0, 022) and prolactin. Also there is significant correlation between dose of risperidone(rho=0.611 ; p=0, 002) and prolactin (mean 1370 mIU/L range=725-1798). There is no correlation between stress (DASS21) and prolactin, neither between cortisol and prolactin levels (r=0, 241 p=0, 336). CONCLUSIONS: When there is demand for determination prolactin in psychiatric patients it can be expected true hyperprolactinemia specially if risperidone is in therapy and patient has severe stage of psychiatric disorder.

prolactin, stress, psychiatric disorder, psychiatric therapy

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