Antipsychotics and pituitary tumors: an analysis of the European pharmacovigilance database (EudraVigilance)

One of the possible long-term consequences of antipsychotic-induced hyperprolactinemia is the development of pituitary tumors – prolactinomas. So far, two pharmacovigilance studies of spontaneous adverse event report databases have suggested an increased risk, whereas a longitudinal study carried out with risperidone showed no evidence of increased risk of tumors with mass effect. Besides, information on amisulpride and paliperidone is lacking. Thus, in this study, we aimed to analyze the European pharmacovigilance database (EudraVigilance) to shed light on this issue. We searched for all suspected spontaneous cases of pituitary tumors associated with antipsychotics in EudraVigilance up to 23 March 2017. To assess the association between pituitary tumor cases and each antipsychotic, we calculated the proportional reporting ratios. Among 4 964 866 events of all types recorded in EudraVigilance, we found 292 cases of pituitary tumors associated with antipsychotics. All atypical antipsychotics except clozapine fulfilled the criteria to generate a safety signal. The highest proportional reporting ratio values were found for amisulpride 51.57 (36.3–73.2), risperidone 21.83 (18.4–25.8), and paliperidone 19.95 (14.7–27.1). Sulpiride and haloperidol showed a higher risk among typical antipsychotics 12.4 (5.89–26.1) and 7.0 (4.35–11.3). Notably, we found that a mass effect was present in 16% of the cases. Besides, 18 cases occurred in ...
Source: International Clinical Psychopharmacology - Category: Psychiatry Tags: SHORT COMMUNICATIONS Source Type: research

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AbstractPurpose of ReviewHypogonadism is a common endocrine dysfunction. This review focuses on the most up-to-date guideline for evaluation of pituitary function among men presenting with signs and symptoms of hypogonadism.Recent FindingsThe clinician must differentiate between primary (testicular) and secondary (pituitary-hypothalamic or central) hypogonadisms and be aware of adult-onset hypogonadism. If gonadotropins are low or inappropriately normal, the clinician must consider potential reversible causes in the hypothalamus-pituitary axis. Also, it is critical to understand the pitfalls of testosterone testing. When c...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
Authors: Kontogeorgos G, Thodou E PMID: 31721137 [PubMed - as supplied by publisher]
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
We present the case of 33-year-old woman with a history of amenorrhea, galactorrhea, elevated prolactin levels, and pituitary tumor. Despite suppression of prolactin levels with cabergoline, the pituitary tumor continued to increase in size and the patient developed clinical symptoms and biochemistry consistent with the diagnosis of acromegaly due to acidophilic stem cell adenoma, an extremely rare subtype of mixed growth hormone/prolactin adenoma, which behaves more aggressively and has a lower surgical cure rate compared to the pure GH-secreting adenoma. The patient had in vitro fertilization 2 years after the successful...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
CONCLUSIONS: HRQOL and neuropsychological impairments were observed in all patients at early timepoints, independent of hypercortisolism, tumor mass, and successful surgery. Over time, CD patients showed persistent changes in HRQOL, in particular in social activities. In this light, CD seems to have a strong impact on HRQOL and to be associated with more psychological and neuropsychological comorbidities than NFPA. PMID: 31731265 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
Pituitary tumors and/or their treatment are associated with multiple pituitary hormone deficiency (MPHD) in adults, but the distinct pituitary hormone profile of MPHD in Chinese children and adolescents remain...
Source: BMC Pediatrics - Category: Pediatrics Authors: Tags: Research article Source Type: research
Conclusion Bipedicled nasal septal flap serves an excellent cover for the skull base defect following endoscopic endonasal transsphenoidal pituitary surgery. It can prevent postoperative CSF leak even in cases where tissue glue is not used. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
Conclusion Endoscopic endonasal resection of macroadenomas with sparing of the pituitary gland in the setting of apoplexy is safe and effective. Preservation of the normal gland led to no posterior pituitary dysfunction, and a statistically significant difference between gender and postoperative endocrinopathy was identified. Further studies with larger samples sizes are warranted. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
Publication date: March 2020Source: Biomedical Signal Processing and Control, Volume 57Author(s): Navid Ghassemi, Afshin Shoeibi, Modjtaba RouhaniAbstractIn this paper, a new deep learning method for tumor classification in MR images is presented. A deep neural network is first pre-trained as a discriminator in a generative adversarial network (GAN) on different datasets of MR images to extract robust features and to learn the structure of MR images in its convolutional layers. Then the fully connected layers are replaced and the whole deep network is trained as a classifier to distinguish three tumor classes. The deep neu...
Source: Biomedical Signal Processing and Control - Category: Biomedical Science Source Type: research
We report the case of a 52-year-old woman who was referred for primary hypothyroidism, who showed clinical signs of hyperthyroidism and had been under treatment with levothyroxine. Her exams revealed high levels of thyroid stimulating hormone (TSH), at odds with free thyroxin (FT4) and raised triiodothyronine (T3), which remained elevated after medication suspension, suggesting possible central hyperthyroidism. Sellar MRI showed normal pituitary gland, with a mass in the sphenoid sinus of 24 mm. A possible ectopic TSH secreting pituitary tumor of sphenoid sinus was hypothesized. After a single dose of a sustained-release p...
Source: Steroids - Category: Drugs & Pharmacology Source Type: research
Abstract Pituitary tumours are a common pathology affecting 15-20% of the population. Only about 1‰ of adenomas are clinically manifested; among them, about two/thirds are hormonally active, most often secreting prolactin or growth hormone. Pituitary tumours are mainly an isolated pathology, without any genetic background. However, the latest studies pay special attention to the possibility of developing an adenoma as a result of genetic mutation. Among pituitary adenomas, the leading group of genetically determined lesions is related to a mutation in AIP or MEN1, followed by PRKAR1A, GRP101, DICER, and SDH...
Source: Endokrynologia Polska - Category: Endocrinology Authors: Tags: Endokrynol Pol Source Type: research
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