정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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아미설프라이드로 유발된 고프로락틴혈증: 예비 연구

Amisulpride-Induced Hyperprolactinemia: Preliminary Study

  • 이정우 (인제대학교 의과대학 일산백병원 신경정신과학교실) ;
  • 박영민 (인제대학교 의과대학 일산백병원 신경정신과학교실) ;
  • 이승환 (인제대학교 의과대학 일산백병원 신경정신과학교실) ;
  • 강승걸 (대구카톨릭대학교 의과대학 정신과학교실) ;
  • 이분희 (카프병원) ;
  • 박은진 (인제대학교 의과대학 일산백병원 신경정신과학교실)
  • Lee, Jung-Woo (Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Park, Young-Min (Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Seung-Hwan (Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kang, Seung-Gul (Department of Psychiatry, Catholic University of Daegu School of Medicine) ;
  • Lee, Bun-Hee (KARF Hospital, The Korean Alcohol Research Foundation) ;
  • Park, Eun-Jin (Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2011.04.30
  • 심사 : 2011.06.10
  • 발행 : 2011.06.30
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초록

연구목적: 고프로락틴혈증은 항정신병약물로 인한 흔한 부작용이다. 그럼에도 불구하고 이러한 고프로락틴혈증에 대한 임상가들의 관심은 적은 편이다. 왜냐하면 고프로락틴혈증으로 인한 부작용의 심각성이 널리 알려지지 않았기 때문이다. 특히 아미설프라이드로 인한 고프로락틴혈증에 대한 국내 연구는 전무한 실정이다. 본 연구에서는 한국인에서의 아미설프라이드로 인한 프로락틴 수치의 변화를 알아보고자 한다. 방 법: 2008년 1월부터 2010년 12월까지 일산백병원 신경정신과의 외래와 입원 환자 24명을 대상으로 의무기록을 검토하여 자료를 분석하였다. 이를 통해 아미설프라이드 사용 전후의 프로락틴 수치의 변화를 비교하였다. 또한 아미설프라이드 용량, 투약 기간과 프로락틴 수치 변화율과의 상관관계를 통계적으로 분석하였다. 결 과: 아미설프라이드를 투여한 모든 환자에서 고프로락틴혈증이 발생하였다. 아미설프라이드 투여 후의 프로락틴 수치는 투여 전 보다 유의하게 상승하였다(z=-3.702, p=0.000). 아미설프라이드 용량과 프로락틴 상승의 정도는 유의한 상관관계를 보였으나(r=0.61, p=0.002), 아미설프라이드 투여 기간과 프로락틴 상승의 정도는 유의한 상관관계를 보이지 않았다. 또한 아미설프라이드 용량과 프로락틴 수치 변화율은 유의한 상관관계를 보이지 않았다. 결 론: 아미설프라이드를 포함한 항정신병약물은 프로락틴 수치를 증가시켜 장 단기간의 부작용을 발생시킬 수 있다. 따라서 아미설프라이드를 사용하는 임상의는 프로락틴 수치를 정기적으로 측정하여야 하며 고프로락틴혈증과 관련된 부작용을 평가하여야 한다.

Objective: Hyperprolactinemia is common side effect associated with antipsychotics use. Nevertheless, hyperprolactinemia is relatively neglected by clinician. Especially, there is no study related to amisulprideinduced hyperprolactinemia in korea. This study aimed to determine whether amisulpride can be induced hyperprolactinemia in Korean psychiatric patients. Methods: This study methodology consisted of a retrospective review of medical charts and prolactin levels. Serum prolactin levels were measured in 24 Korean patients(12 males and 12 females) with psychosis who were treated over 400mg of amisulpride per day. Results: All patients had hyperprolactinemia. Prolactin levels significantly increased after receiving amisulpride(z=-3.702, p=0.000). The prolactin level was significantly higher in females($156.29{\pm}63.75$ng/mL) than in males($69.04{\pm}39.91$ng/mL) after administering amisulpride(p=0.000). There was a correlation between dosage and prolactin levels(r=0.61, p=0.002). However, there was no correlation between duration of treatment and prolactin levels. Conclusions: Antipsychotics, especially amisulpride can increase serum prolactin levels and may results in short and long term side effects. Routine clinical assessment of initial and additional prolactin level and associated symptoms should be done

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