Psychiatry Investig.  2016 Jan;13(1):89-101. 10.4306/pi.2016.13.1.89.

Parameters of Calcium Metabolism Fluctuated during Initiation or Changing of Antipsychotic Drugs

• Milovanovic DR
• Stanojevic Pirkovic M
• Zivancevic Simonovic S
• Matovic M
• Djukic Dejanovic S
• Jankovic S
• Ravanic D
• Petronijevic M
• Ignjatovic Ristic D
• Mladenovic V
• Jovanovic
• Nikolic Labovic S
• Pajovic M
• Djokovic D
• Petrovic D
• Janjic V

• KMID: 2316601
• DOI: http://doi.org/10.4306/pi.2016.13.1.89

Abstract

OBJECTIVE
Serum parameters of calcium homeostasis were measured based on previously published evidence linking osteoporotic fractures and/or bone/mineral loss with antipsychotics.
METHODS
Prospective, four-week, time-series trial was conducted and study population consisted of patients of both genders, aged 35-85 years, admitted within the routine practice, with acute psychotic symptoms, to whom an antipsychotic drug was either introduced or substituted. Serial measurements of serum calcium, phosphorous, magnesium, 25(OH)D, parathyroid hormone, calcitonin, osteocalcin and C-telopeptide were made from patient venous blood samples.
RESULTS
Calcium serum concentrations significantly decreased from baseline to the fourth week (2.42+/-0.12 vs. 2.33+/-0.16 mmol/L, p=0.022, n=25). The mean of all calcemia changes from the baseline was -2.6+/-5.7% (-24.1 to 7.7) with more decreases than increases (78 vs. 49, p=0.010) and more patents having negative sum of calcemia changes from baseline (n=28) than positive ones (n=10) (p=0.004). There were simultaneous falls of calcium and magnesium from baseline (63/15 vs. 23/26, p<0.001; OR=4.75, 95% CI 2.14-10.51), phosphorous (45/33 vs. 9/40, p<0.001; 6.06, 2.59-14.20) and 25(OH)D concentrations (57/21 vs. 13/35, p<0.001; 7.31, 3.25-16.42), respectively. Calcemia positively correlated with magnesemia, phosphatemia and 25(OH)D values. Parathyroid hormone and C-telopeptide showed only subtle oscillations of their absolute concentrations or changes from baseline; calcitonin and osteocalcin did not change. Adjustment of final calcemia trend (depletion/accumulation) for relevant risk factors, generally, did not change the results.
CONCLUSION
In patients with psychotic disorders and several risks for bone metabolism disturbances antipsychotic treatment was associated with the decrease of calcemia and changes in levels of the associated ions.

Keyword

Antipsychotic agents; Bone and bones; Calcium; Minerals; Blood chemical analysis

MeSH Terms

Antipsychotic Agents*
Blood Chemical Analysis
Bone and Bones
Calcitonin
Calcium*
Homeostasis
Humans
Ions
Magnesium
Metabolism*
Minerals
Osteocalcin
Osteoporotic Fractures
Parathyroid Hormone
Prospective Studies
Psychotic Disorders
Risk Factors
Antipsychotic Agents
Calcitonin
Calcium
Ions
Magnesium
Minerals
Osteocalcin
Parathyroid Hormone