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Cited by 92Schizophrenia research and treatmentBone health and osteoporosis researchPharmacological Effects and Toxicity Studies

Bone mineral density changes over a year in young females with schizophrenia: Relationship to medication and endocrine variables

Meaney, A.M., O'Keane, V.·2007·Schizophrenia Research
DOI 10.1016/j.schres.2007.01.013
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Abstract

Introduction Hyperprolactinaemia is associated with the use of potent dopamine-2 receptor blocking anti-psychotic agents in schizophrenia and with bone loss in the general population. Significantly higher rates of reduced bone mineral density (BMD) have been identified in young pre-menopausal females with schizophrenia receiving prolactin-raising anti-psychotics compared to those receiving prolactin-sparing anti-psychotics. This prospective study compared BMD alterations over a period of 1 year in patients maintained on either prolactin-raising (e.g. risperidone, amisulpride or depot anti-psychotics) or prolactin-sparing (olanzapine) anti-psychotics. The effects of specific interventions to improve BMD were also examined in the context of whether patients were receiving either prolactin-raising or anti-psychotics or Olanzapine.Methods Pre-menopausal females (n=38) with a diagnosis of schizophrenia, who had received exclusively either prolactin-raising (n=25) or prolactin-sparing (n=13) anti-psychotics during their treatment history, had clinical, endocrine and bone marker assessments performed at baseline and every 3 months for a period of 1 year. BMD was measured by DEXA scan at baseline and at 1-year follow-up. Patients from both groups either received specific interventions (n=16) or no interventions (n=16) to improve bone density.Results There was an overall gain in lumbar BMD values in the prolactin-sparing subgroup, compared to an overall loss in the prolactin-raising subgroup (p=0.02), for the groups that received no specific interventions to improve BMD. Within the group that received specific interventions, the subgroup receiving prolactin-sparing anti-psychotics had a significant increase in lumbar (p=0.01) and hip (p=0.01) BMD over time, whereas alterations in the prolactin-raising subgroup were not significant.Discussion Women taking prolactin-raising anti-psychotics and not receiving specific interventions to improve bone density had evidence of ongoing bone demineralisation over a year; whereas women taking prolactin-sparing anti-psychotics had a modest overall increase in BMD. Most clinical interventions appeared to be helpful, but were significantly more effective in those taking prolactin-sparing anti-psychotics.

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Crossref · 10.1016/j.schres.2007.01.013

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  • Some studies found a relationship between the use of prolactin-raising medication and low bone mineral density in patients with chronic schizophrenia, while others failed to find a relationship between prolactin, antipsychotics and osteoporosis.

    “Some studies (490-493) found a relationship between the use of prolactin-raising medication and low BMD in patients with chronic schizophrenia, while others (474,489,494-498) failed to find a relationship between prolactin, AP and osteoporosis.”

    From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [492]

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Authors
Meaney, A. M., & O'Keane, V.
Affiliations
Beaumont Hospital (IE)
Corresponding author
Meaney, A.M.
Venue
Schizophrenia Research
Publisher
Elsevier BV
Published
2007-07
Volume
93
Issue
1-3
Pages
136-143
ISSN
0920-9964 (ISSN-L)
DOI
10.1016/j.schres.2007.01.013
OpenAlex
W1967310658
Cited by
92
References
24
Citations by year
2025: 2 · 2024: 6 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 6 · 2015: 7 · 2014: 3 · 2013: 6 · 2012: 7
FWCI
6.04
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Schizophrenia Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
Keywords
bone mineral density, schizophrenia
MeSH terms
Adult, Calcium, Dietary, Cholecalciferol, Combined Modality Therapy, Estradiol, Female, Follow-Up Studies, Humans, Osteoporosis, Prolactin, Prospective Studies, Referral and Consultation, Schizophrenia, Antipsychotic Agents, Exercise, Absorptiometry, Photon, Bone Density, Estrogen Replacement Therapy, Premenopause

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