Psychotropic medication use and bone loss in men: longitudinal study

Psychotropic medication use has been shown to be associated with decreased bone mineral density (BMD) and quality, and increased fracture risk. Less is known about psychotropic use and associated bone loss over time.

To determine the association between psychotropic medication use and bone loss in men.

Data from 940 men (aged ≥20 years) participating in the Geelong Osteoporosis Study were used in this longitudinal study. BMD (g/cm²) at the spine and hip were measured with dual-energy X-ray absorptiometry at baseline, and 5 and 15 years post-baseline. Body mass index (BMI) was calculated, lifestyle factors and medication use was self-reported, and socioeconomic status was determined. Mood and anxiety disorders were identified through a clinical interview. Multivariable linear regression was used to determine the associations.

Over the study period (median 13.2 years), psychotropic use was associated with change in BMD at the spine (unadjusted mean difference -0.063 g/cm², 95% CI -0.096 to -0.031, p < 0.001) and hip (-0.038 g/cm², 95% CI -0.059 to -0.017, p < 0.001). BMI was identified as an effect modifier. Psychotropic use was associated with spine and hip bone loss at the 25th (adjusted mean difference -0.077g/cm² (95% CI -0.122 to -0.033); and -0.058 g/cm² (95% CI -0.084 to -0.032), respectively) and 50th percentile (adjusted mean difference -0.053 g/cm² (95% CI -0.089 to -0.018) and -0.038 g/cm² (95% CI -0.059 to -0.017), respectively), but not the 75th percentile of BMI (p = 0.121 and p = 0.106, respectively).

Psychotropic use was associated with bone loss in non-obese men, highlighting the need for regular monitoring and preventive strategies to protect bone health.