Hyperprolactinaemia

Biochemistry pitfalls

Macroprolactin - make sure it's been excluded.

Hook effect - many assays suffer from this, so request measurement at 1:10 or 1:100 dilution if expected to be high.

Drug causes of hyperprolactinaemia

Class Subclass Drug Effect
CR = case reports. Based on Molitch, Mayo Clin Proc 2005.
Antipsychotics Typical Phenothiazines +++
Butyrophenones +++
Thioxanthenes +++
Atypical Risperidone +++
Clozapine 0
Quetiapine +
Olanzapine +
Antidepressants Tricyclics Amitriptyline +
Clomipramine +++
Imipramine CR
MAO inhibitors MAOI +++
SSRIs Fluoxetine CR
Paroxetine +/-
Citalopram +/-
Fluvoxamine +/-
Other Bupropion 0
Venlafaxine 0
Trazodone 0
Antihypertensives   Verapamil  
Methyldopa  
Reserpine  
Gastrointestinal   Metoclopramide  
Domperidone  
Histamine2 blockers  
Oestrogens      
Opiates and cocaine      

Causes Of Hyperprolactinaemia

Physiological

Other pathological

Prolactinomas

Treatment

Pregnancy