The Association Between Antipsychotics and Bone Fragility: An Updated Comprehensive Review
Michele Mercurio1,2, Giovanna Spina1, Olimpio Galasso3
1Department of Orthopaedic and Trauma Surgery, Magna Graecia University, "Renato Dulbecco" University Hospital, V.le Europa, (Loc. Germaneto), 88100 Catanzaro, Italy.
Diagnostics (Basel, Switzerland)
|December 17, 2024
Summary
Long-term antipsychotic use may increase the risk of reduced bone mineral density (BMD), leading to bone fragility and fractures. This risk affects all patients, not just vulnerable groups, highlighting the need for clinical awareness.
Area of Science:
- Pharmacology
- Bone Metabolism
- Gerontology
Background:
- Antipsychotic medications are frequently associated with decreased bone mineral density (BMD).
- A comprehensive review of existing literature was performed to investigate this relationship.
Purpose of the Study:
- To synthesize available research on the association between antipsychotic drug use and bone fragility.
- To evaluate the impact of antipsychotics on bone metabolism and fracture risk.
Main Methods:
- A narrative review of studies identified through PubMed, Scopus, and Cochrane libraries.
- Inclusion criteria encompassed studies assessing bone metabolism, osteoporosis, or fracture risk in patients receiving antipsychotic treatment.
Main Results:
- Fifteen papers were included from 1707 initially screened items, analyzing 1357 patients on antipsychotics.
- Two studies reported significant lumbar BMD reduction in antipsychotic users compared to controls.
- Two case-control studies found significant femoral neck BMD reduction in the antipsychotic-exposed group.
Conclusions:
- Prolonged antipsychotic treatment is linked to reduced BMD and increased risk of bone fragility and fractures.
- This risk extends beyond vulnerable populations to all long-term antipsychotic users.
- Clinicians must be aware of this risk to optimize antipsychotic therapy and mitigate bone-related complications.
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