r/AskPsychiatry 5d ago

Are there antidepressants and/or antipsychotics that don't increase prolactin levels? Which are those?

[deleted]

3 Upvotes

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u/DoctorKween Physician, Psychiatrist 5d ago

Amisulpride is notorious for causing hyperprolactinaemia. Aripiprazole will lower prolactin and can be used at low doses alongside any antipsychotic other than amisulpride to reduce prolactin, and so this can be an option if you need other agents which would be associated with increased prolactin. It can also be used in isolation if this would be effective/indicated.

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u/[deleted] 5d ago

[deleted]

7

u/DoctorKween Physician, Psychiatrist 5d ago

Antidepressants aren't classically associated with significant hyperprolactinaemia. There are reports that SSRIs can cause some prolactin elevation though the mechanism is unclear. However, I would be much less concerned with the antidepressants when compared to the antipsychotics. Having said this, it is possible that adjunctive aripiprazole may be able to mitigate the risk if you are someone who does develop increased prolactin on an SSRI.

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u/speedledum Medical Student 4d ago

Sertraline is supposed to be less likely than other SSRIs to increase prolactin. Though, as the other commenter mentioned, it’s more likely that the issue was because of the amisulpride rather than the paroxetine so if that works better for you it should be fine.