Hyperprolactinemia is a known adverse drug reaction to antipsychotic treatment. Antipsychotic blood levels are influenced by cytochrome P450 enzymes, primarily CYP2D6. Variation in CYP450 genes may affect the risk of antipsychotic-induced hyperprolactinemia. We undertook a systematic review and meta-analysis to assess whether CYP2D6 functional genetic variants are associated with antipsychotic-induced hyperprolactinemia. The systematic review identified 16 relevant papers, seven of which were suitable for the meta-analysis (n = 303 participants including 134 extreme metabolisers). Participants were classified into four phenotype groups as poor, intermediate, extensive, and ultra-rapid metabolisers. A random effects meta-analysis was used and Cohen's d calculated as the effect size for each primary study. We found no significant differences in prolactin levels between CYP2D6 metabolic groups. Current evidence does not support using CYP2D6 genotyping to reduce risk of antipsychotic-induced hyperprolactinemia. However, statistical power is limited. Future studies with larger samples and including a range of prolactin-elevating drugs are needed.

中文翻译：

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CYP2D6变异对抗精神病药诱发的高泌乳素血症的影响：系统评价和荟萃分析。

高泌乳素血症是抗精神病药物的已知药物不良反应。抗精神病药的血液水平受细胞色素P450酶（主要是CYP2D6）的影响。CYP450基因的变异可能会影响抗精神病药诱发的高泌乳素血症的风险。我们进行了系统的审查和荟萃分析，以评估CYP2D6功能性遗传变异是否与抗精神病药诱发的高泌乳素血症相关。系统评价确定了16篇相关论文，其中7篇适合进行荟萃分析（n = 303名参与者，其中包括134种极端代谢者）。参与者分为不良，中度，广泛和超快速代谢者四个表型组。使用随机效应荟萃分析，并计算Cohen d作为每个主要研究的效应量。我们发现CYP2D6代谢组之间催乳素水平无显着差异。当前证据不支持使用CYP2D6基因分型来降低抗精神病药诱发的高泌乳素血症的风险。但是，统计能力有限。未来需要对更大的样本进行研究，包括一系列催乳激素升高药物。