Sex differences in prolactin levels and clinical outcomes in patients with a first psychotic episode.

To analyze the clinical, neurocognitive, and functional impact of prolactin levels according to sex in patients with a First Episode Psychosis (FEP). We measured prolactin levels in 221 non-affective FEP patients treated with antipsychotics (AP) and 224 healthy controls, at baseline and 2-year follow-up. We examined whether the relationships between clinical and functional variables were mediated by prolactin, controlling for antipsychotic use, according to sex. Prolactin levels were higher in patients when compared to controls at both time points. Baseline factors associated with prolactin were chlorpromazine equivalents, attention, and executive functioning. In the FEP group, prolactin levels were associated with functioning and diminished expression in males, and with working memory in females. Prolactin levels (p=0.0134) played a role as a mediator between negative symptomatology (p=0.086) and functional outcome (p=0.008) only in FEP male patients at baseline. Prolactin plays a role in the functionality and clinical symptomatology of FEP patients. Our results suggest that pharmacological counselling in patients with hyperprolactinemia at baseline and negative symptomatology might improve their functional and clinical outcomes.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest E. Vieta has received grants and served as consultant, advisor or CME speaker for the following entities (unrelated to the present work): AB-Biotics, Abbott, Allergan, Angelini, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, Janssen, Lundbeck, Otsuka, Sage, Sanofi-Aventis, and Takeda. M. Bernardo has been a consultant for, received grant/ research support and honoraria from, and been on the speakers/advisory board (unrelated to the present work) of ABBiotics, Adamed, Angelini, Casen Recordati, Janssen-Cilag, Menarini, Rovi and Takeda. N. Verdolini has received financial support for CME activities and travel funds from the following entities (unrelated to the present work): Angelini, Janssen-Cilag, Lundbeck, Otsuka. A. Tortorella has received research support from Lundbeck and served as speaker for Lundbeck and Angelini (unrelated to the present work). G. Menculini received travel grants from Angelini and Janssen and served as speaker or advisor for Angelini, Janssen and Laborest (unrelated to the present work). CM. Díaz-Caneja has received grant support from Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (PI17/00481, PI20/00721, JR19/00024), travel support from Janssen and Angelini, and honoraria from Angelini (unrelated to the present work). S. Amoretti has been a consultant to and/or has received honoraria/grants from Otsuka-Lundbeck, with no financial or other relationship relevant to the subject of this article. A. Ibáñez has received research support from or served as speaker or advisor for Janssen-Cilag, Lundbeck, Otsuka and Casen Recordati (unrelated to the present work). IBaeza has received honoraria and travel support (unrelated to the present work) from Angelini, Otsuka-Lundbeck and Janssen, as well as research support from the Fundación Alicia Koplowitz and grants from the Spanish Ministry of Health, Instituto de Salud Carlos III (F.I.S.-PI21/0391, cofunded by European Union), National Drugs Plan (2022I053) and Pons-Bartran legacy (FCRB_IPB2_2023). R. Rodriguez-Jimenez has been a consultant for, spoken in activities of, or received grants from: Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (FIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid Regional Government (S2010/ BMD-2422 AGES; S2017/BMD-3740), JanssenCilag, Lundbeck, Otsuka, Pfizer, Ferrer, Juste, Takeda, Exeltis, Casen-Recordati, Angelini, Rovi (unrelated to the present work). L. González-Blanco has received CME-related honoraria unrelated to the present work from Angelini, Janssen-Cilag, Casen Recordati, Lundbeck, Otsuka and Pfizer. Paz Garcia-Portilla has been a consultant to and/or has received honoraria/grants from Alter, Angelini, Cassen-Recordati, Janssen-Cilag, Idorsia, Lundbeck, Otsuka, and SAGE Therapeutics (unrelated to the present work). C Garcia-Rizo has served as consultant, advisor or received honoraria/travel support (unrelated to the present work) from Adamed, Angelini, Casen-Recordati, Janssen-Cilag, Lundbeck, Otsuka and Newron. Dr. Roldán has served as advisor or speaker for the companies Otsuka and Angelini (unrelated to the present work). The rest of authors report no biomedical financial interests or potential conflicts of interest related to the present work.