Psychiatria Danubina, Vol. 28 No. 3, 2016.
Original scientific paper
THE EFFECT OF ANTIPSYCHOTICS ON BONE MINERAL DENSITY AND SEX HORMONES IN MALE PATIENTS WITH SCHIZOPHRENIA
Süheyla Dogan Bulut
; Dıskapı Yıldırım Beyazıt Teaching and Research Hospital, Department of Psychiatry, Ankara, Turkey
Serdar Bulut
; Yenimahalle Teaching and Research Hospital, Department of Psychiatry, Ankara, Turkey
Dicle Görkem Atalan
; Dıskapı Yıldırım Beyazıt Teaching and Research Hospital, Department of Psychiatry, Ankara, Turkey
Rıza Gökçer Tulaci
; Dıskapı Yıldırım Beyazıt Teaching and Research Hospital, Department of Psychiatry, Ankara, Turkey
Eda Gürçay
; Dıskapı Yıldırım Beyazıt Teaching and Research Hospital, Physical Medicine and Rehabilitation Department, Ankara, Turkey
Abstract
Background: The aim of this study was to compare the bone mineral density (BMD) of male schizophrenia patients with those of
healthy controls in order to determine the relationship between BMD and hormonal changes.
Subjects and methods: The study sample included male outpatients between 18 and 55 years old, diagnosed with schizophrenia
who had used prolactin-raising antipsychotics (n=23) and prolactin-sparing antipsychotics (n=19) for at least twelve months, along
with an age– matched healthy control group. A socio-demographic form was administered, BMD and T-score measurements were
performed with a DEXA test, and hormone levels were measured with commercial test kits.
Results: The prolactin levels of the prolactin-raising group (PRG) were significantly higher than those of the healthy control
group (CG) and the prolactin-sparing group (PSG). While prolactin levels were normal in the CG, hyperprolactinemia was found in
15.8% (n=3) of patients in the PSG and 65.2% (n=15) of subjects in the PRG. Estradiol levels for the PRG and PSG were similar but
significantly lower than those of the CG. There was a statistically significant difference between the PRG, PSG and CG in terms of
their L1-4 total actual bone density and T-scores. BMD and T-scores were lower for the PRG in comparison with the PSG and CG,
and were consistent with osteopenia. Although not observed for every tested region, a negative correlation was found between age,
duration of therapy, duration of illness, and T-scores. A positive correlation was found between subjects BMI and T-scores. A
consistent negative correlation was found between total testosterone and L1-4 total T-scores when corrected according to prolactin
and estradiol. A linear regression analysis found significant relationships between age, BMI, duration of therapy, duration of illness,
chlorpromazine equivalent dose, estradiol and testosterone affected T-scores for some regions.
Conclusions: The long-term use of prolactin – raising antipsychotic medications as well as hyperprolactinemia and
hypoestrogenism accelerate bone degradation.
Keywords
schizophrenia; bone mineral density; antipsychotics; osteoporosis
Hrčak ID:
176262
URI
Publication date:
15.9.2016.
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