Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Osteoporosis
Abstract number: 23449
THE ROLE OF ANTIPSYCHOTICS IN OSTEOPOROSIS AND FRACTURE
INCIDENCE: IN VITRO AND IN VIVO STUDIES.
Simon GRAHAM
Leeds General Infirmary, Academic Orthopaedic Unit, Leeds (UNITED KINGDOM)
Antipsychotics are increasingly used to treat the vast majority of patients with
schizophrenia and bipolar disease. Blocking the D2 receptors in the mesolimbic
pathway in the brain is believed to reduce and control psychotic experiences. (1)
Although antipsychotics remain the mainstay of treatment in schizophrenic patients,
recent evidence has suggested that they may also have an adverse effect on bone
mineral architecture and fracture incidence. (2, 3) Antipsychotics have a variable side
effect profile including acute dystonias and Parkinsonism but clinical trials have
shown hyperprolactinaemia to be one of the commonest adverse effects reported in
association with the majority of antipsychotics (4). Charoenphandhu et al
demonstrated that in female rats prolactin decreased the expression of Runt-related
transcription factor 2 (Runx2), osteoprotegerin, and receptor activator of nuclear
factor kappaBeta ligand (RANKL), essential genes for osteoblast differentiation and
function leading to increased bone loss. (5) A recent case control study including
16,341 hip fractures on the General Practice Research Database with 29,889
matched controls reported a statistically significant association between prolactin
raising antipsychotics and hip fractures. (6) Furthermore, a study comparing
ultrasound bone mass in 73 schizophrenic patients on antipsychotic therapy with a
matching number of healthy subjects demonstrated increased bone loss in
schizophrenic patients on antipsychotic therapy. (2) The aim of this
poster/presentation study is to explain and summarize the current literature
surrounding the use of antipsychotics and their effect on bone mineralization and
fracture incidence.
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