Which antipsychotics are associated with increased Prolactin levels?

• A. Quetiapine, Risperidone
• B. Risperidone, Paliperidone
• C. Clozapine, Aripiprazole
• D. Olanzapine, Ziprasidone

Answer: (B)

Risperidone and paliperidone are both associated with increased prolactin levels due to their mechanism of action as potent antagonists at the D2 dopamine receptors in the mesolimbic pathway. Blocking these receptors can lead to an elevation in prolactin secretion, as dopamine normally inhibits prolactin release from the anterior pituitary gland. This side effect is significant because elevated prolactin levels can lead to various problems, including galactorrhea, amenorrhea, and sexual dysfunction.

Risperidone is particularly well-known for causing hyperprolactinemia, and since paliperidone is the active metabolite of risperidone, it shares this side effect as well. Other antipsychotics listed do not have the same level of association with increased prolactin. For instance, quetiapine, clozapine, aripiprazole, olanzapine, and ziprasidone generally have less propensity to raise prolactin levels, with aripiprazole actually possessing some antipsychotic properties that may lower prolactin. This highlights the specific impact of the medications listed in the correct answer on prolactin levels.