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Antipsychotic Drugs: Typical and Atypical Agents01:21

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Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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Related Experiment Video

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Second-generation antipsychotics and bone turnover in schizophrenia.

Kyoji Okita1, Nobuhisa Kanahara2, Motoi Nishimura3

  • 1Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan.

Schizophrenia Research
|June 4, 2014
PubMed
Summary

Schizophrenia patients on antipsychotics face osteoporosis risk. This study found higher prolactin and lower bone resorption markers (TRACP-5b), suggesting complex bone density loss causes.

Keywords:
AntipsychoticsBone turnoverOsteoporosisSchizophreniaTRACP-5b

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Bone Metabolism

Background:

  • Long-term antipsychotic treatment in schizophrenia patients is linked to increased osteoporosis/osteopenia risk.
  • The specific impact of antipsychotics on bone mineral density (BMD) loss remains unclear.
  • Bone turnover markers may offer a more precise method for assessing bone health in psychiatric populations.

Purpose of the Study:

  • To investigate the relationship between hormonal levels, bone resorption markers, and BMD in schizophrenia patients.
  • To explore the potential role of hyperprolactinemia and sex hormone suppression in bone density changes.
  • To evaluate the utility of tartrate-resistant acid phosphatase 5b (TRACP-5b) as a marker for bone loss pathology in schizophrenia.

Main Methods:

  • Measured serum prolactin, estradiol, and testosterone levels.
  • Assessed bone resorption marker tartrate-resistant acid phosphatase 5b (TRACP-5b).
  • Compared levels between 167 schizophrenia patients and 60 healthy controls.

Main Results:

  • Schizophrenia patients exhibited significantly higher prolactin and lower TRACP-5b levels than controls.
  • Prolactin negatively correlated with estradiol and testosterone in males.
  • TRACP-5b showed positive correlation with prolactin in female patients and negative correlation with estradiol in females.

Conclusions:

  • Bone resorption appears attenuated in schizophrenia patients, indicating a complex etiology for BMD loss.
  • Hyperprolactinemia likely suppresses sex hormones, potentially influencing bone turnover.
  • TRACP-5b measurement may aid in clarifying the pathophysiology of BMD loss in schizophrenia.