From the FDA Drug Label
Prolactin increased The answer is yes, venlafaxine can increase prolactin levels 1.
From the Research
Venlafaxine can increase prolactin levels in some patients, as evidenced by a case report where a patient developed gynecomastia and had increased serum prolactin levels while on venlafaxine therapy 2.
Key Points to Consider
- The increase in prolactin levels is thought to be due to the inhibition of dopamine, which normally suppresses prolactin secretion, by the increased serotonin levels caused by venlafaxine 2.
- Most cases of venlafaxine-induced hyperprolactinemia are mild and may not cause symptoms, but some patients might experience galactorrhea, menstrual irregularities in women, or sexual dysfunction.
- The effect is typically dose-dependent, with higher doses more likely to cause prolactin elevation.
- If problematic hyperprolactinemia occurs, options include dose reduction, switching to an antidepressant less likely to affect prolactin, or in some cases, adding a dopamine agonist to counteract the prolactin increase.
Relevant Studies
- A study from 2009 reported a case of venlafaxine-induced gynecomastia in a young patient, where laboratory tests revealed increased serum prolactin levels 2.
- Other studies have investigated the effects of different antidepressants on prolactin levels, but the most relevant study to this question is the one directly linking venlafaxine to increased prolactin levels 2.
Clinical Implications
- If a patient on venlafaxine develops symptoms suggestive of hyperprolactinemia, such as galactorrhea or menstrual irregularities, checking prolactin levels would be appropriate.
- Clinicians should be aware of the potential for venlafaxine to increase prolactin levels and monitor patients accordingly, especially when using higher doses or in patients with a history of hormonal imbalances.