ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet13036ometendo-13036Research ArticleОБЗОРREVIEWЛекарственно-индуцированная гиперпролактинемия: механизм развития, особенности диагностики и леченияDrug-induced hyperprolactinemia: mechanism of development, features of diagnosis and treatmenthttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна, д.м.н.

eLibrary SPIN: 2958-5555

Москва

Larisa K. Dzeranova, MD, PhD

Moscow

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dzeranovalk@yandex.ruhttps://orcid.org/0000-0001-7470-1676ВоротниковаС. Ю.VorotnikovaS. Y.

Воротникова Светлана Юрьевна, к.м.н.

eLibrary SPIN: 6571-1206

Москва

Svetlana Y. Vorotnikova, MD, PhD

Moscow

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bra_svetix@list.ruhttps://orcid.org/0000-0003-0047-7223ШутоваА. С.ShutovaA. S.

Шутова Александра Сергеевна, аспирант

eLibrary SPIN: 4774-0114

Москва

Aleksandra S. Shutova, MD, postgraduate student

Moscow

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shutova.aleksandra@gmail.comhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна, д.м.н.

eLibrary SPIN: 6912-6331

Москва

Ekaterina A. Pigarova, MD, PhD

Moscow

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kpigarova@gmail.comhttps://orcid.org/0000-0001-6009-9872ЕвлоеваМ. И.YevloyevaM. I.

Евлоева Мадина Иссаевна, аспирант

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г. Москва, ул. Дмитрия Ульянова, д. 11, 117036

Madina I. Yevloyeva, MD, postgraduate student

11 Dm. Ulyanova street, 117036 Moscow

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madevis_6@mail.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation202314112023203251258Copyright © Дзеранова Л.К., Воротникова С.Ю., Шутова А.С., Пигарова Е.А., Евлоева М.И., 20232023Дзеранова Л.К., Воротникова С.Ю., Шутова А.С., Пигарова Е.А., Евлоева М.И.Dzeranova L.K., Vorotnikova S.Y., Shutova A.S., Pigarova E.A., Yevloyeva M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/13036

Одной из причин неопухолевой гиперпролактинемии является прием ряда лекарственных препаратов. С гиперпролактинемией как побочным эффектом медикаментозной терапии в своей практической деятельности встречаются врачи различных специальностей: кардиологи, гастроэнтерологи, эндокринологи, неврологи, но чаще всего она наблюдается в практике врача-психиатра при лечении пациентов психотропными препаратами. За последние несколько лет отмечается повышение частоты назначений антидепрессантов и нейролептиков в связи с постковидным синдромом, тревожностью и стрессом, вызванными пандемией новой коронавирусной инфекции. Также существует предрасположенность к развитию гиперпролактинемии на фоне приема нейролептиков из-за генетических особенностей пациентов. В настоящее время в мире не существует установленного общего алгоритма диагностики и лечения лекарственно-индуцированной гиперпролактинемии. В статье на основе обзора зарубежной и отечественной литературы подробно обсуждаются механизмы развития и различные подходы к коррекции ятрогенной (лекарственной) гиперпролактинемии, проводится оценка пролактогенной активности нейролептиков, предлагаются алгоритмы мониторинга пролактина и коррекции гиперпролактинемии с использованием агонистов дофамина. Часто тактику ведения таких пациентов необходимо обсуждать командой врачей-специалистов.

One of the causes of non-tumor related hyperprolactinemia is taking a medications. Physicians of various specialties, such as cardiologists, gastroenterologists, endocrinologists, and neurologists, encounter hyperprolactinemia as a side effect of drug therapy in their practice, but it is most often observed in the practice of a psychiatrist when treating patients with psychotropic medications. Over the past few years, there has been an increase in the frequency of prescriptions of antidepressants and neuroleptics due to post-COVID-19 syndrome, anxiety and stress caused by the pandemic of a new coronavirus infection. There is also a predisposition to the development of hyperprolactinemia on the background of taking neuroleptics due to genetic features of patients. Currently, there is no established common algorithm for diagnosis and treatment of drug-induced hyperprolactinemia in the world. Based on a review of foreign and domestic literature, the article discusses in detail the mechanisms of development and various approaches to the correction of iatrogenic (drug-induced) hyperprolactinemia, assesses the prolactogenic activity of neuroleptics, and proposes algorithms for prolactin monitoring and correction of hyperprolactinemia using dopamine agonists. Often the tactics of management of such patients need to be discussed by a team of specialized physicians.

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The authors declare that there are no conflicts of interest present.