Switching to aripiprazole from other antipsychotics can avoid antipsychotic-induced hyperprolactinemia but may result in an abnormally low prolactin level. This study aimed to assess whether the aripiprazole-induced abnormally low prolactin level was a biomarker for subsequent rebound of positive symptoms in schizophrenia patients. Participants were 63 patients in an 8-week trial of switching to aripiprazole, in which preswitching antipsychotics were maintained for the first 2 weeks and aripiprazole was fixed at 15 mg orally throughout the trial. A prolactin level of < 3.7 ng/ml was defined as abnormally low, and an increase of two or more points in the positive subscore of the Positive and Negative Syndrome Scale at two adjacent ratings was defined as a psychotic rebound. Among 63 patients, 25 (39.7%) had an abnormally low prolactin level and 21 (33.3%) had a psychotic rebound after switching to aripiprazole. In patients with abnormally low prolactin levels, 48.0% of them had a rebound in psychotic symptoms, whereas in those without abnormally low prolactin levels 23.7% did so. Multivariable logistic regression analysis with adjustment for sex, early age at onset, and preswitching medications revealed that abnormally low prolactin levels were associated with psychotic rebound (adjusted odds ratio = 3.55, 95% confidence interval = 1.02, 12.5). Furthermore, there was concurrency between the trend of the cumulative proportion of patients having an abnormally low prolactin level and that of the cumulative proportion of patients having a rebound in psychotic symptoms. An abnormally low prolactin level after switching to aripiprazole in schizophrenia patients was a potential warning sign of a psychotic rebound. Hence, monitoring of prolactin levels after switching to aripiprazole may help avoid such rebound in schizophrenia. NCT00545467 ; Date of registration: 17/10/2007.

中文翻译：

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在一项随机试验中，改用阿立哌唑后精神分裂症患者的催乳素水平异常低：一种精神病症状反弹的生物标志物？

从其他抗精神病药转向阿立哌唑可以避免抗精神病药引起的高泌乳素血症，但可能导致催乳素水平异常低。这项研究旨在评估阿立哌唑诱导的催乳素水平异常低是否是精神分裂症患者阳性症状随后反弹的生物标志物。在为期8周的改用阿立哌唑试验中，共有63名患者参加，其中前2周维持转用抗精神病药，整个试验期间口服阿立哌唑固定为15 mg。催乳素水平<3.7 ng / ml被定义为异常低，而阳性和阴性综合症量表的阳性子评分在两个相邻等级上增加两个或更多点被定义为精神病性反弹。在63例患者中，有25例（39。改用阿立哌唑后，有7％的人的催乳素水平异常低，有21例（33.3％）的患者出现了精神病性反弹。泌乳素水平异常低的患者中，有48.0％的患者出现精神病症状的反弹，而泌乳素水平异常的患者中有23.7％的患者出现了精神症状的反弹。多变量logistic回归分析，对性别，发病年龄和服用转换前药物进行了调整，发现催乳素水平异常低与精神病性反弹有关（校正优势比= 3.55，95％置信区间= 1.02，12.5）。此外，催乳素水平异常低的患者的累积比例与精神病性症状反弹的患者的累积比例之间存在并发性。精神分裂症患者改用阿立哌唑后泌乳素水平异常低是精神病性反弹的潜在警告信号。因此，在改用阿立哌唑后监测催乳素水平可能有助于避免精神分裂症的反弹。NCT00545467; 注册日期：17/10/2007。