Efficacy And Safety Of Aripiprazole In The Treatment Of Antipsychotic-induced Hyperprolactinemia:A Meta-analysis

Background Hyperprolactinemia is common as a side effect in the treatment of mental illness,the short term it can cause amenorrhea and galactorrhea,for a long time can lead to osteoporosis and cancer,which not only affects the patients’ quality of life,but also reduces medication compliance.In recent years,the role of aripiprazole in the treatment of antipsychotic drugs induced hyperprolactinemia has made significant progress,but the research results are various.In this respect,there have been relevant systematic reviews,but for the reason which the small number of included studies and the difference of analysis index,so there are still many uncertainties about the long-term safety and efficacy of aripiprazole in the treatment of hyperprolactinemia.Objectives System evaluation the clinical efficacy and safety of aripiprazole in the treatment of antipsychotic-induced hyperprolactinemia,and provide evidence-based medicine evidence for clinical treatment.Methods Retrieved relevant RCTs(randomized controlled trials)from Pub Med,Lilacs,BMC(Bio Med Central),CNKI,Wanfang and VIP databases,by the time December 2015,according to predefined inclusion and exclusion criteria for screening,the quality of methodology were assessed by Jadad scale,used Rev Man5.3 software for data entry and index analysis,comprehensive evaluation the results.Results A total of 28 RCTs were recruited,including 2387 cases,the study group 1248 cases and the control group 1139 cases.Which 17 were rated as high quality literature,11 were rated as low quality literature.Meta-analysis showed that:1.Compared with the control group,aripiprazole group significantly increased the proportion of prolactin levels returned to normal,and the difference was statistically significant(RR=25.39,95%CI: 14.52~44.39,P<0.00001);High-dose aripiprazole(>5mg/d)was more effective than low-dose(<5mg/d)aripiprazole(RR=50.50 v.RR=17.26),but the difference was not statistically significant.2.The overall incidence of treatment-emergent adverse event was similar in two groups(RR=1.06,95%CI: 0.81~1.37,P=0.68),and the risk ratio between the high-dose and low-dose(RR=1.02 v.RR=1.08)there was no significant difference.3.The last total score of BPRS(Brief Psychiatric Rating Scale)and PANSS(Positive and Negative Syndrome Scale)had no statistically significant between the two groups(SMD=-0.05,95%CI:-0.20~0.10,P=0.49;SMD=-0.08,95%CI:-0.25~0.09,P=0.37).4.Compared with the control group,serum prolactin levels in aripiprazole group was significantly decreased after 4 weeks treatment,the difference was statistically significant(SMD=-1.74,95% CI:-2.31~-1.17,P<0.00001).5.Under the same therapeutic doses,the decline rate of prolactin levels in aripiprazole group was not significant difference between different genders(SMD=-0.20,95%CI:-0.64~0.24,P=0.38).ConclusionsThe existing clinical research evidence shows that adjunctive treatment with aripiprazole for other antipsychotic-induced hyperprolactinemia is safe and effective.