Osteoporosis Associated with Antipsychotic Treatment in Schizophrenia

Wu, Haishan; Deng, Lu; Li-pin, Zhao; Zhao, Jingping; Li, Lehua; Chen, Jindong

doi:10.1155/2013/167138

Cited by 35 publications

(32 citation statements)

References 65 publications

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“…Schizophrenia and bipolar disorder are associated with lower bone mineral density (BMD) and higher prevalence of osteoporosis compared to the general population . The etiology of BMD loss in these patients is complicated .…”

Section: Musculoskeletal Diseasesmentioning

confidence: 99%

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

et al. 2015

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People with severe mental illness have a considerably shorter lifespan than the general population. This excess mortality is mainly due to physical illness. Next to mental illness-related factors, unhealthy lifestyle, and disparities in health care access and utilization, psychotropic medications can contribute to the risk of physical morbidity and mortality. We systematically reviewed the effects of antipsychotics, antidepressants and mood stabilizers on physical health outcomes in people with schizophrenia, depression and bipolar disorder. Updating and expanding our prior systematic review published in this journal, we searched MEDLINE (November 2009 -November 2014, combining the MeSH terms of major physical disease categories (and/or relevant diseases within these categories) with schizophrenia, major depressive disorder and bipolar disorder, and the three major psychotropic classes which received regulatory approval for these disorders, i.e., antipsychotics, antidepressants and mood stabilizers. We gave precedence to results from (systematic) reviews and meta-analyses wherever possible. Antipsychotics, and to a more restricted degree antidepressants and mood stabilizers, are associated with an increased risk for several physical diseases, including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, hyponatremia; cardiovascular, respiratory tract, gastrointestinal, haematological, musculoskeletal and renal diseases, as well as movement and seizure disorders. Higher dosages, polypharmacy, and treatment of vulnerable (e.g., old or young) individuals are associated with greater absolute (elderly) and relative (youth) risk for most of these physical diseases. To what degree medication-specific and patient-specific risk factors interact, and how adverse outcomes can be minimized, allowing patients to derive maximum benefits from these medications, requires adequate clinical attention and further research.

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Section: Musculoskeletal Diseasesmentioning

confidence: 99%

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

et al. 2015

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“…Al compararlos con la población normal, los pacientes con EQZ presentan una prevalencia mayor de osteoporosis y fracturas óseas, así como una densidad mineral ósea marcadamente disminuida 35,36 . Los factores de riesgo para osteoporosis que se han identificado en esta población se pueden agrupar en dos tipos: modificables y no modificables.…”

Section: Osteoporosisunclassified

“…Los factores no modificables incluyen edad avanzada, raza asiática o caucásica e historia familiar de osteoporosis. En cuanto al sexo existen resultados controversiales en diversos estudios con respecto a pacientes que sufren de EQZ 36 .…”

Section: Osteoporosisunclassified

“…Los mecanismos de osteoporosis inducida por antipsicóticos son complejos, pero probablemente el de mayor importancia es la hiperprolactinemia, causada por la mayoría de los antipsicóticos, aunque siendo este evento más marcado con el uso de risperidona, paliperidona y amisulpiride. El mecanismo de hiperprolactinemia sería el bloqueo del receptor dopaminérgico D2 en el lactótrofo, lo que anula la función inhibitoria de la dopamina sobre la secreción de prolactina 36 .…”

Section: Osteoporosisunclassified

“…La hiperprolactinemia inducida por antipsicóticos puede afectar el metabolismo óseo de dos maneras: afecta directamente el recambio óseo al estimular la reabsorción ósea y la hiperprolactinemia prolongada puede causar hipogonadismo hipogonadotropo, que supone una disminución en la secreción de hormonas sexuales, lo cual influye en el metabolismo óseo (el hipoestrogenismo aumenta el riesgo de osteoporosis, y los bajos niveles de testosterona se asocian a osteopenia y osteoporosis) 36 .…”

Section: Osteoporosisunclassified

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Esquizofrenia y su asociación con enfermedades médicas crónicas

et al. 2017

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The life expectancy of patients with schizophrenia (SCH) is 11 to 20 years less than the general population. There is an association between SCH and various diseases and chronic conditions, highlighting the cardio-metabolic diseases. This association has been attributed to the use of antipsychoticsSe caracteriza por síntomas positivos (alucinaciones, delirio, síntomas catatónicos y discurso desorganizado), negativos (aplanamiento afectivo y anhedonia) y disfunciones cognitivas (alteración de atención, memoria y funciones ejecutivas) 1 . Además, hay perturbaciones fisiológicas severas que aumentan la gravedad de la EQZ, de hecho, se evidencian alteraciones endocrinológicas, del sueño, cardiovasculares y metabólicas con alteración del peso, regulación de glicemia, metabolismo lipídico y presión arterial, cuyos mecanismos no se conocen del todo 2 .La expectativa de vida de los pacientes con EQZ es entre 11 y 20 años menor que la población general y la mortalidad cardiovascular ha aumentado en este grupo de pacientes, en contraste a la población general 3 .El tratamiento antipsicótico siempre se ha asociado a estas alteraciones cardiometabólicas, sin embargo, la evidencia muestra que pacientes que nunca han recibido tratamiento también presentan estas patologías concomitantes 4 , además que muchas de ellas se encuentran desde el primer episodio psicótico, por ende, se postula que la EQZ per se estaría relacionada con esta alteración 5,6 .Este trabajo pretende actualizar los conocimientos con respecto a comorbilidades médicas crónicas asociadas a la EQZ y ayudar así a optimizar el manejo clínico de estos pacientes.

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Gender‐specific risk factors for low bone mineral density in patients taking antipsychotics for psychosis

Jhon

Yoo

Lee

et al. 2018

Human Psychopharmacology

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Objective: This study examined clinical and gender-specific risk factors for low bone mineral density (BMD) in adult patients with psychotic disorders. Methods:The study included 285 community-dwelling patients with psychotic disorders. Dual-energy X-ray absorptiometry was used to measure BMD. Clinical characteristics associated with low BMD were identified with logistic regression analysis in total population and each gender.Results: Fifty-eight (20.4%) subjects had low BMD. Low BMD was more common in men and in patients with low body mass indices (BMIs), as well as in those with shorter treatment durations, those on Medicaid, and patients using serotonergic antidepressants. Logistic regression analysis revealed that low BMD was negatively associated with BMI and treatment duration and positively with gender (male) and serotonergic antidepressants use in the overall population. In men, low BMD was associated with treatment duration and BMI; in women, low BMD was associated with BMI, prolactin level, vitamin D, and serotonergic antidepressant use. Conclusion:Managing the risk factors associated with low BMD among patients with psychotic disorder should be done gender-specifically. Psychotropic agents should be prescribed mindful of their effects on bone, as use of these medications is a modifiable risk factor for osteoporosis in women with psychotic disorders. KEYWORDS body mass index, bone mineral density, prolactin, psychosis, schizophrenia, serotonergic antidepressant

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Osteoporosis Associated with Antipsychotic Treatment in Schizophrenia

Cited by 35 publications

References 65 publications

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

Esquizofrenia y su asociación con enfermedades médicas crónicas

Gender‐specific risk factors for low bone mineral density in patients taking antipsychotics for psychosis

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