February 15, 2007

Increased Osteoporosis Risk Linked to Prolactin-Raising Antipsychotics

An earlier study we've reported on raised the question of whether some antipsychotics used for schizophrenia might raise the risk of osteoporosis (possibly through elevation of prolactin levels), over other atypical antipsychotics that are not prone to raising prolactin levels.

A more recent study in the British Journal of Psychiatry further investigates the link between antipsychotic medications and the risk of hip fracture (osteoporosis). The investigators found that the risk of hip fracture was indeed elevated from prolactin-raising antipsychotics used in patients with schizophrenia. Prolactin-raising antipsychotics include the first-generation, or "typical", antipsychotics, and the atypical antipsychotic, Risperidone.

The authors suggest that patients taking long-term prolactin-raising antipsychotic drugs have preventative measures against thinning bones included as part of their treatment. The authors say that preventative, bone-density maintaining measures may include

"advice to patients about the importance of a balanced diet containing sufficient amounts of calcium and vitamin D, regular weight-bearing exercise, avoidance of tobacco, caffeine and alcohol, and sufficient exposure to sunlight."

Thanks to Tim^ for providing the source article.

Source Abstract: "Risk of hip fracture in patients with a history of schizophrenia" (Br J Psychiatry 2007; 190: 129–134)
Additional Reading:
Fracture Risk Higher with Some Antipsychotics?
Antipsychotics and Prolactin
Sexual Side Effects of Antipsychotic Meds


Comments

Does anyone have any knowledge about mixing antipsychotic medications?
I've read in neurology journals that it is considered relatively safe
but is usually only used for more extreme cases. But I'm thinking
about very mild doses. For example, a very small dose of Abilify and
Geodon. Considering that one is a partial agonist and the other is a
full antagonist, and that they affect slightly different receptor
sites, I'm unsure exactly what the results would be. Sometimes I feel I have nothing to lose. I will probably try the combination next week sometime.

Posted by: Cory Schulz at February 16, 2007 09:27 PM

You may get many responses by posting this question on one of the Discussion Boards.

I have noticed that some doctors say that sometimes mixing two drugs at lower doses can cause less side-effects, and be more effective than one drug at a high dose.


Posted by: Jeanie at February 17, 2007 06:31 AM

LS, The authors say that preventative, bone-density maintaining measures may include

"advice to patients about the importance of a balanced diet containing sufficient amounts of calcium and vitamin D, regular weight-bearing exercise, avoidance of tobacco, caffeine and alcohol, and sufficient exposure to sunlight."
I guess it is easier to take risperdal of the market than to have SZ-patients do all that....

Posted by: sebastiaan koning at February 17, 2007 03:15 PM

I am okay now but I was diagnosed schizophrenic when I was 12 and was on heavy medication till I was about 15. I have not taken any medication since I was 15. After reading about the increased risk of bone-thinning with prolactin raising medications I am wondering if this may be the reason my bones are so skinny. (I can bend my elbows backwards)

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