Protective Effect of Hyperprolactinemia on Oxidative Stress in Patients with Psychotic Disorder on Atypical Antipsychotics Risperidone and Paliperidone: A Cross-Sectional Study

Abstract

Several studies indicate the impact of antipsychotics like risperidone and paliperidone on oxidative stress parameters, yet data remain inconsistent. We investigated the link between these medications, hyperprolactinemia (HPRL), and oxidative stress. This study was conducted at the Psychiatry Clinic, University Clinical Center, Kragujevac, between November 2022 and August 2023. Inclusion criteria comprised diagnosed psychotic disorders from the ICD-10-based F20-F29 spectrum and clinical stability on risperidone/paliperidone for ≥12 weeks with no recent dose adjustments. Exclusion criteria included pregnancy, breastfeeding, relevant medical conditions, or co-therapy with prolactin-secreting drugs. Data encompassed drug choice, administration method, therapy duration, and daily dose. Prolactin (PRL) levels, oxidative stress parameters (TBARS, H2O2, O2−, NO2−), and antioxidant system (CAT, GSH, SOD) were assessed. Of 155 subjects, women exhibited significantly higher PRL levels (p < 0.001) and symptomatic HPRL (p < 0.001). Drug choice and regimen significantly influenced TBARS (p < 0.001), NO2− (p < 0.001), O2− (p = 0.002), CAT (p = 0.04), and GSH (p < 0.001) levels. NO2− levels were affected by drug dose (p = 0.038). TBARS (p < 0.001), O2− (p < 0.001), and SOD (p = 0.022) inversely correlated with PRL levels, suggesting PRL’s protective role against oxidative stress. The female sex association with higher PRL levels implies additional factors influencing PRL’s antioxidant role. Antipsychotic choice and dosage impact PRL and oxidative stress markers, necessitating further exploration.