Hyperprolactinaemia is a common side effect of some APS, associated to important clinical manifestations (sexual dysfunction, breast disturbances and even increase of certain types of cancer risk).

To evaluate the levels of prolactinemia associated to different APS, including the newest ones, and its association with sexual dysfunction (SD).

Observational cross-sectional study. Adult patients treated with one APS for at least 4 weeks and with no other PRL-rising treatment were included. Hyperprolactinaemia was defined as 20 microgr/L in women, 18 microgr/L in men. SD was evaluated with the specific SD questionnaire PR-Sex-DQ-SALSEX (Montejo et al, 2001).

288 patients were evaluated, with the following APS treatment distribution: aripiprazol (22.2%), risperidone (17.01%), olanzapine (16.67%), quetiapine (7.99%), long-acting paliperidone (6.25%), long-acting risperidone (4.51%), oral paloperidone (4.17%), oral risperidone (4.17%) and others (21.18%; APS with N<10 were not evaluated). Paliperidone was associated with the higher mean PRL levels (98.28 and 71.48 microgr/L for LAP and OP respectively), followed by oral risperidone (71.36 microgr/L). Aripiprazol, oral olanzapine and quetiapine showed the lowest PRL levels (13.25, 27.10 and 28.55 microgr/L respectively). More than 70% of the sexually active patients treated with paliperidone or risperidone presented SD, less frequent in non PRL-raising APS.

In our sample paliperidone and risperidone were associated to higher mean PRL levels and sexual disfunction, while quetiapine, olanzapine and aripiprazol were the less PRL-raising APS. This might be taken in consideration when electing a long-term antipsychotic treatment for patients, given the important clinical consequences associated to sustained hyperprolactinaemia.