리스페리돈으로 유발된 무월경에 대한 아리피프라졸 부가치료

Adjunctive Treatment with Aripiprazole for Risperidone-Induced Amenrrhea

본 연구는 아리피프라졸 부가치료가 리스페리돈으로 인해 발생되는 고프로락틴혈증 및 이와 동반된 무월경 치료에 효과적임을 지지했다. 그러나 아리피프라졸 부가치료가 리스페리돈 감량, 도파민 효현제 부가 치료, 아리피프라졸 단독 투여로 교체하는 방법들과 비교해서 효과, 안정성 및 경제성에서 우수한가에 대해선 여전히 검증이 필요하다. 리스페리돈에 의해 유발된 무월경치료에 어느 방법을 선택할 것인가는 환자의 개인적인 특성을 고려한 임상의의 판단이 중요하리라 사료된다.

Objective Hyperprolactinemia and associated side effect, amenorrhea, often occur with risperidone treatment. We investigated the effect of adjunctive treatment with aripiprazole on risperidone induced amenorrhea in female patients with schizophrenia. Methods A retrospective chart review of 24 female patients with adjunctive aripiprazole treatment for risperidone induced amenorrhea between August 2008 and July 2009 was conducted. The information collected included age, menstrual cycle, duration of no menstruation, prolactin level (before aripiprazole treatment and after regaining menstruation), dose of risperidone and aripiprzole, time from starting aripiprazole adjunctive treatment to regaing menstruation. The Student s t-test, Pearson s Chi-square test were used for data analysis. Results Mean percent decrease in prolactin level for all aripiprazole-treated patients was 71.4±8.6%. 85.7% (18/21) of patients resumed menstruation, while 14.3% (3/21) did not regain. In patients with regaining menstruation, mean time from starting aripiprazole to restarting menstruation was 6.6±2.4 weeks, mean dose of aripiprazole was 12.2±3.9 mg/day (dose range, 5mg to 20 mg/day). Aripiprazole dose for regaining menstruation was not significantly correlated with baseline prolactin level. CGI score was not significantly changed after aripiprazole treatment. The cutoff point of prolactin level significantly increasing amenorrhea was 40 ng/mL. Conclusion Adjunctive aripiprazole treatment is very effective to treat risperidone induced amenorrhea in female patients with schizophrenia.