title: Relationship between antipsychotic medication, serum prolactin levels and osteoporosis/osteoporotic fractures in patients with schizophrenia: a critical literature review.
abstract: BACKGROUND
  Using an antipsychotic medication can increase prolactin (PRL) levels, causing hyperprolactinemia (HPRL). Although the occurrence of osteoporosis within the population of patients with schizophrenia has been recognized, the precise nature of the association between antipsychotic treatment, PRL, osteoporosis, and the disease itself seems to be elusive.
  
  
  METHODS
  The aim of this review is to critically review the literature regarding the association between osteoporosis and PRL and to summarize the available evidence with respect to the impact of PRL-elevating antipsychotics on bone mineral density (BMD) and fractures in non-elderly patients with schizophrenia.
  
  
  CONCLUSIONS
  Although long-standing HPRL can have an impact on the rate of bone metabolism and, when associated with hypogonadism, may lead to decreased bone density in both female and male subjects, the relative contribution of antipsychotic-induced HPRL in bone mineral loss in patients with schizophrenia remains unclear. Methodological shortcomings of existing studies, including the lack of prospective data and the focus on measurements of BMD instead of bone turnover markers, preclude definitive conclusions regarding the relationship between PRL-raising antipsychotics and BMD loss in patients with schizophrenia. Therefore, more well conducted prospective trials of these biomarkers are necessary to establish the precise relationship between antipsychotics, PRL levels and osteoporosis/osteoporotic risk.
authors.affiliation: a Department of Neurosciences , KU Leuven - University Psychiatric Centre , Kortenberg , Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Hert
authors.affiliation: a Department of Neurosciences , KU Leuven - University Psychiatric Centre , Kortenberg , Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Detraux
authors.affiliation: b Physiotherapy Department , South London and Maudsley NHS Foundation Trust , Denmark Hill, London , United Kingdom.|c Health Service and Population Research Department , Institute of Psychiatry, King's College London , London , United Kingdom.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced* / Q000150:complications; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology; D011388:Prolactin / Q000097:blood*; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy
chemical_list: D014150:Antipsychotic Agents; D011388:Prolactin
keywords: Hyperprolactinemia; antipsychotic; fracture; osteoporosis; prolactin; schizophrenia