The effect of antipsychotics on bone mineral density in bipolar disorder: a case-controlled pilot study

The purpose of this study was to evaluate the effect of antipsychotics on bone mineral density in bipolar disorder. A total of 44 premenopausal female patients receiving antipsychotic medication for at least 1 year and 43 healthy premenopausal female volunteers were included in the present study. Clinical evaluation was performed via Hamilton Depression Scale and Clinical Global Impression Scale, bone metabolism via serum levels of calcium, phosphorus, parathormone, alkaline phosphatase (ALP), vitamin D and prolactin, while bone mineral density via dual energy X-ray absorptiometry. Bone mineral density scores were determined to be significantly lower, while prolactin, parathormone and ALP levels were significantly higher in the patient group. Comparison of patient group in itself based on patients under atypical antipsychotic vs. atypical antipsychotic + mood stabilizer treatment revealed no significant difference between groups in terms of clinical and biochemical parameters. In conclusion, contrary to what many studies suggest, our findings revealed that atypical antipsychotics offered no advantages over other medications in the development of secondary osteoporosis in patients with bipolar disorder. There was no significant difference between patients receiving atypical antipsychotics and other mood stabilizers in terms of osteoporosis incidence.