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[Psychiatric side effects associated with diphosphonate treatment]
B H R Wolffenbuttel1, M M van der Klauw
1Academisch Ziekenhuis, afd. Endocrinologie, Postbus 30.001, 9700 RB Groningen. bwo@int.azg.nl
Nederlands Tijdschrift Voor Geneeskunde
|February 5, 2003
Summary
Cyclic etidronic acid, used for osteoporosis, may cause rare psychiatric side effects like mood and memory problems. Symptoms improved after drug withdrawal and returned upon re-administration.
Area of Science:
- Pharmacology
- Neuroscience
- Geriatrics
Background:
- Bisphosphonates, including etidronic acid, are commonly prescribed for osteoporosis.
- While generally well-tolerated, adverse events can occur.
- Gastrointestinal issues and esophageal ulcers are the most frequently reported side effects.
Observation:
- Three patients (two women, one man) treated with cyclic etidronic acid for osteoporosis developed mood, concentration, and memory problems.
- These neurological and psychological symptoms emerged after months to years of treatment.
- Two patients experienced similar issues with other bisphosphonates (pamidronic acid, alendronic acid).
Findings:
- Patient-reported psychiatric complaints, including mood disturbances and cognitive deficits, were linked to bisphosphonate therapy.
- Symptoms resolved within weeks of discontinuing the medication.
- Reintroduction of the drug led to the recurrence of these adverse effects, suggesting a causal relationship.
Implications:
- Psychiatric side effects should be considered in patients on bisphosphonate therapy, particularly those with unexplained mood or cognitive changes.
- Further research is warranted to understand the mechanisms underlying these rare but significant adverse events.
- This highlights the importance of comprehensive patient monitoring for a full spectrum of potential bisphosphonate side effects.