SynthesisCNS drugs2025
Antipsychotic-Related Prolactin Changes: A Systematic Review and Dose-Response Meta-analysis.
Synthesis in CNS drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Positive and Negative Symptoms Changes in Schizophrenia Patients on Antipsychotic Treatment: a Systematic Review and Dose-Response Meta-analysis.Schizophrenia bulletin · 2026Pooled it
- Clinical Practice Guideline on the Choice of First Antipsychotic Medicine for Females Experiencing a First-Episode of Psychosis.Schizophrenia bulletin · 2026Guideline
- Translating Pharmacokinetics and Pharmacodynamics into Clinical Decision-Making: A Practical Guide to the Use of Risperidone ISMJournal of clinical medicine · 2026Review
- Next-step treatment for schizophrenia non-responsive to antipsychotics: a systematic review and network meta-analysis.EClinicalMedicine · 2026Article
- Antipsychotic dose and efficacy for acute schizophrenia spectrum disorders: an updated systematic review and dose-response meta-analysis.EClinicalMedicine · 2026Article
- Emerging Neurobiological and Therapeutic Insights into Schizophrenia: A Comprehensive Review.International journal of molecular sciences · 2026Review
- Antipsychotic prescribing patterns and determinants in first-episode psychosis: a 2019-2024 cross-sectional study from Zambia.BMC psychiatry · 2026Article
- Strategic Timing of Resistance Training to Guard Against Antipsychotic-Induced Metabolic Syndrome (START GAAIMS): A Feasibility Study Protocol.HRB open research · 2026Article
- Risk of hyperprolactinemia and extrapyramidal symptoms in antipsychotic-treated schizophrenia: a retrospective single-center real-world study.Frontiers in pharmacology · 2026Article
- Adjunctive aripiprazole for amisulpride-induced hyperprolactinemia: a preliminary retrospective study showing no reversing effect.Therapeutic advances in psychopharmacology · 2026Article
- Empowering clinicians and patients in antipsychotic dose reduction for schizophrenia: the role of online tools.Schizophrenia (Heidelberg, Germany) · 2025Article
- Rehospitalization risk in community-dwelling schizophrenia patients receiving paliperidone palmitate: a retrospective cohort study in urban China.BMC psychiatry · 2025Article
- Schizophrenia.Nature reviews. Disease primers · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
Abstract
backgroundProlactin increase is a common and potentially problematic adverse event of antipsychotics. We aimed to discover the relationship between antipsychotic doses and changes in prolactin levels.
objectiveTo examine the relationship between antipsychotic doses and changes in prolactin levels in adults with acutely exacerbated schizophrenia.
methodsWe searched the Cochrane Schizophrenia Group register (last search 26 July 2024) and previous reviews for fixed-dose, randomized controlled trials (RCTs) that investigated monotherapy of 21 antipsychotics in adults with acutely exacerbated schizophrenia. The primary outcome was mean prolactin change from baseline to study endpoint adopting mean differences (MD) in ng/mL as the effect size measure. The dose-response curves were estimated by conducting random-effects dose-response meta-analyses using the restricted cubic spline method.
resultsAmong 165 eligible studies, 68 studies with 238 dose arms (23,128 participants, 35% female) reported on prolactin and were meta-analyzed. Of these, 94% lasted ≤ 3 months, and 90% of the studies used oral formulations. Participants in one study experienced their first episode, while all other studies also included multiepisode participants. The dose-response curves indicated that with aripiprazole, higher doses were significantly associated with lower prolactin levels than lower doses. Brexpiprazole, cariprazine, lumateperone, and quetiapine carried negligible risks for prolactin increase across examined doses. During treatment with most other antipsychotics, i.e., asenapine, haloperidol, iloperidone, lurasidone, olanzapine, paliperidone, risperidone, and ziprasidone, prolactin levels rose with increasing doses and then continued to increase or plateaued. The shape of the dose-response curves was similar in males and females, with generally larger amplitudes of the curves in females.
conclusionsThe prolactin-increasing property varies among antipsychotics, is dose-related, and is greater in females. These findings in adults with acutely exacerbated schizophrenia can help clinicians titrate and adapt antipsychotic doses and consider patients' sex in treatment decisions. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO); registration no. CRD42020181467.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.