Clin Psychopharmacol Neurosci.  2016 Aug;14(3):238-249. 10.9758/cpn.2016.14.3.238.

Effects of Antipsychotics on Bone Mineral Density in Patients with Schizophrenia: Gender Differences

• Chen CY
• Lane HY
• Lin CH

• KMID: 2348471
• DOI: http://doi.org/10.9758/cpn.2016.14.3.238

Abstract

Low bone mineral density (BMD) and osteoporosis are common in patients with schizophrenia and detrimental to illness prognosis and life quality. Although the pathogenesis is not fully clear, series of studies have revealed factors related to low BMD such as life style, psychotic symptoms, medication use and the activity of bone absorption markers. It has been known that antipsychotic-induced hyperprolactinemia plays a critical role on decreased BMD. However, it remains uncertain whether the risk factors differ between men and women. According to the effect on prolactin, antipsychotics can be classified into two groups: prolactin-sparing (PS) and prolactin-raising (PR). Our previous study has demonstrated that clozapine which is among the PS antipsychotics is beneficial for BMD when compared with PR antipsychotics in women with chronic schizophrenia. We have also found that risks factors associated with low BMD are different between men and women, suggesting that gender-specific risk factors should be considered for intervention of bone loss in patients with schizophrenia. This article reviews the effects of antipsychotics use on BMD with particular discussion for the differences on gender and age, which implicate the alterations of sex and other related hormones. In addition, currently reported protective and risk factors, as well as the effects of medication use on BMD including the combination of antipsychotics and other psychotropic agents and other potential medications are also reviewed.

Keyword

Schizophrenia; Bone density; Gender effects; Antipsychotics agents; Hyperprolactinemia

MeSH Terms

Absorption
Antipsychotic Agents*
Bone Density*
Clozapine
Female
Humans
Hyperprolactinemia
Life Style
Male
Osteoporosis
Prognosis
Prolactin
Quality of Life
Risk Factors
Schizophrenia*
Antipsychotic Agents
Clozapine
Prolactin