title: Parameters of Calcium Metabolism Fluctuated during Initiation or Changing of Antipsychotic Drugs.
abstract: OBJECTIVE
  Serum parameters of calcium homeostasis were measured based on previously published evidence linking osteoporotic fractures and/or bone/mineral loss with antipsychotics.
  
  
  METHODS
  Prospective, four-week, time-series trial was conducted and study population consisted of patients of both genders, aged 35-85 years, admitted within the routine practice, with acute psychotic symptoms, to whom an antipsychotic drug was either introduced or substituted. Serial measurements of serum calcium, phosphorous, magnesium, 25(OH)D, parathyroid hormone, calcitonin, osteocalcin and C-telopeptide were made from patient venous blood samples.
  
  
  RESULTS
  Calcium serum concentrations significantly decreased from baseline to the fourth week (2.42±0.12 vs. 2.33±0.16 mmol/L, p=0.022, n=25). The mean of all calcemia changes from the baseline was -2.6±5.7% (-24.1 to 7.7) with more decreases than increases (78 vs. 49, p=0.010) and more patents having negative sum of calcemia changes from baseline (n=28) than positive ones (n=10) (p=0.004). There were simultaneous falls of calcium and magnesium from baseline (63/15 vs. 23/26, p<0.001; OR=4.75, 95% CI 2.14-10.51), phosphorous (45/33 vs. 9/40, p<0.001; 6.06, 2.59-14.20) and 25(OH)D concentrations (57/21 vs. 13/35, p<0.001; 7.31, 3.25-16.42), respectively. Calcemia positively correlated with magnesemia, phosphatemia and 25(OH)D values. Parathyroid hormone and C-telopeptide showed only subtle oscillations of their absolute concentrations or changes from baseline; calcitonin and osteocalcin did not change. Adjustment of final calcemia trend (depletion/accumulation) for relevant risk factors, generally, did not change the results.
  
  
  CONCLUSIONS
  In patients with psychotic disorders and several risks for bone metabolism disturbances antipsychotic treatment was associated with the decrease of calcemia and changes in levels of the associated ions.
authors.affiliation: Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Dragan R
authors.initials: DR
authors.lastname: Milovanovic
authors.affiliation: Department of Biochemistry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Stanojevic Pirkovic
authors.affiliation: Department of Pathophysiology, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Snezana
authors.initials: S
authors.lastname: Zivancevic Simonovic
authors.affiliation: Deparment of Nuclear Medicine, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Milovan
authors.initials: M
authors.lastname: Matovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Slavica
authors.initials: S
authors.lastname: Djukic Dejanovic
authors.affiliation: Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Slobodan M
authors.initials: SM
authors.lastname: Jankovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Ravanic
authors.affiliation: Clinic of Rheumatology, Military Medical Academy University of Defense, Belgrade, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Petronijevic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Ignjatovic Ristic
authors.affiliation: Clinic of Internal Diseases, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Violeta
authors.initials: V
authors.lastname: Mladenovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Jovanovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Nikolic Labovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Marina
authors.initials: M
authors.lastname: Pajovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Djokovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Dusan
authors.initials: D
authors.lastname: Petrovic
authors.affiliation: Clinic of Psychiatry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Janjic
keywords: Antipsychotic agents; Blood chemical analysis; Bone and bones; Calcium; Minerals