Does trazodone cause hyperprolactinemia? (+3 factors)

In this article, we will investigate the potential induction of hyperprolactinemia by trazodone. We’ll explore research studies examining any correlation between trazodone use and elevated prolactin levels. Additionally, we will discuss the risk factors that may contribute to the development of trazodone-induced hyperprolactinemia and explore management strategies if such symptoms arise during trazodone treatment.

Does trazodone cause hyperprolactinemia?

Yes, trazodone may cause hyperprolactinemia. Research studies have reported that trazodone may increase prolactin levels in some individuals taking this medication, potentially leading to subsequent hyperprolactinemia. However, it’s important to note that this side effect does not occur in all patients receiving trazodone.

Trazodone is generally indicated for the management of various mental disorders, including depression and anxiety, as well as other health conditions like fibromyalgia and chronic pain. Commonly reported side effects of this medication may include dizziness, nausea, fatigue, headaches, and dry mouth (1). 

What does research suggest?

According to research, the use of trazodone can cause an increase in the concentration of prolactin, which can result in hyperprolactinemia in some individuals.

In a research study involving over 100 patients for managing depression, the use of trazodone at a daily dosage of 150 mg led to elevated levels of prolactin after a month of treatment (2). Another study reported hyperprolactinemia in a patient after using trazodone for approximately 6 months (3).

In yet another research study, the use of trazodone at a daily dosage of 100 mg resulted in elevated levels of prolactin and subsequent hyperprolactinemia, along with galactorrhea in a patient after a few weeks of treatment (4).

What factors may influence trazodone-induced hyperprolactinemia?

Generally, trazodone is less commonly associated with causing elevated levels of prolactin, however, certain risk factors and conditions may contribute to an increased risk of hyperprolactinemia with this medication. These factors may include:

Concurrent Medications: The concurrent use of trazodone with medications known to elevate prolactin levels may increase the risk. Medications such as antipsychotics, certain antidepressants, and some medications for gastrointestinal issues may impact prolactin levels.

Underlying Medical Conditions: Conditions affecting the hypothalamus or pituitary gland, such as tumors or diseases, can disrupt the normal regulation of prolactin and lead to elevated levels. In these cases, trazodone or other medications may have a secondary impact on prolactin levels.

Hormonal Changes: Hormonal changes, such as those occurring during pregnancy or breastfeeding, can naturally increase prolactin levels. Trazodone use during these periods may interact with hormonal changes.

What to do if trazodone causes hyperprolactinemia?

While trazodone is not commonly associated with hyperprolactinemia, it can manifest in certain individuals. If you observe symptoms related to high levels of prolactin or any other unusual effects after taking trazodone, it is essential to consult your healthcare provider promptly.

Your healthcare provider will assess your symptoms, identifying the root cause. If there are concurrent risk factors contributing to these symptoms, your healthcare provider will address them as a priority.

However, if trazodone is identified as the primary cause of hyperprolactinemia, your healthcare provider may recommend adjustments in dosage or consider discontinuation of the medication, depending on the severity of the symptoms.

In some instances, alternative medications with a lower likelihood of causing hyperprolactinemia may be suggested. However, the choice of an appropriate alternative should be tailored to individual health considerations to ensure the effectiveness and safety of the treatment.

How to manage trazodone-induced hyperprolactinemia?

Management of hyperprolactinemia involves various interventions, depending on the underlying cause and symptoms.

• The use of medications like bromocriptine and cabergoline, which are effective in lowering the levels of prolactin caused by trazodone, are employed to manage trazodone-induced hyperprolactinemia. These medications work by increasing the activity of dopamine in the body.

• Additionally, in cases where hormonal imbalances occur after using trazodone, contributing to hyperprolactinemia, your healthcare provider may recommend hormone replacement therapy to improve your condition.

• If underlying mental conditions are contributing to trazodone-induced hyperprolactinemia, your healthcare provider may address these conditions with specialized interventions.

• Lifestyle modifications and a balanced diet may also be recommended, contributing to overall well-being while following the treatment plan.

Addressing trazodone-induced hyperprolactinemia requires a thoughtful strategy. In my opinion, tailoring interventions, such as medication adjustments and hormonal therapies, alongside mental health considerations, under the guidance of a healthcare provider, is crucial for effective management.

References