Весьма сомнительной( мягко говоря:)) представляется целесобразность комбинации традиционного нейролептика и атипичного антипсихотика (галоперидол+рисполепт).

Dr.Admin, скажите пожалуйста, какой уровень пролактина можно считать критическим? У меня пролактин 1405 мМЕ/л. Верхняя граница нормы для мужчин 500 мМЕ/л.

Endocrine Hyperprvtactinemia is a well-documented reaction to risperidone (SEDA 28. 77). There was a high correlation between pro¬lactin concentrations and risperidone in 14 men (mean age 53 years) C124с). In 47 men (mean age 23 years) receiving acute treatment with several neuroleptic drugs, including risperidone (mean dose 3.6. range 1-6. mg; mean duration 45 days; risperidone monotherapy in 35 subjects), there was hyperprolactinemia, defined as a prolactin concentration greater than 636 mU/l (male reference range 45-375 mlU/1), in 27 of the 37 patients who could be assessed (125с). There was neither gynecomastia nor galactor¬rhea. One year later. 38 of the 47 patients were reassessed (mean dose 2.3. range 1-6. mg); prolactin concentrations could be determined in 20 of these patients, and there was hyperprolactinemia in six of them. In the 35 patients taking risperidone monotherapy, two had high prolactin concentrations at baseline, but this rose to 21 of 29 patients at the end of the acute phase and fell to four of 16 after I year. According to the authors, the lower concentrations at I year might have been due to the develop¬ment of tolerance to prolactin.

• A 35-year-old woman who had taken lithium carbonate 800 mg/day for 2 years was also given risperidone 6 mg/day for a manic relapse. She missed two mensirual periods and had galactorrhea. A head CT scan showed a pituitary mi¬croadenoma and the prolactin concentration was 125 ng/l I reference range up to 20 ng/l). Risperi¬done withdrawal resulted in disappearance of the prolactinoma. Her other symptoms persisted and did not change with olanzapine 2.5 mg/day; however, bromocriptine 12.5 mg/day for 2 weeks relieved her symptoms and the prolactin concentration normalized.
There were no significant adverse effects on growth or sexual maturation in a retrospective study based on a sample of 700 children aged 5-15 years who had been taking risperidone (0.02-0.06 mg/kg/day) for 11 or 12 months because of disruptive behavior disorders (126c).