title: The Effect of Antipsychotics on Bone Mineral Density and Sex Hormones in Male Patients with Schizophrenia.
abstract: BACKGROUND
  The aim of this study was to compare the bone mineral density (BMD) of male schizophrenia patients with those of healthy controls in order to determine the relationship between BMD and hormonal changes.
  
  
  METHODS
  The study sample included male outpatients between 18 and 55 years old, diagnosed with schizophrenia who had used prolactin-raising antipsychotics (n=23) and prolactin-sparing antipsychotics (n=19) for at least twelve months, along with an age - matched healthy control group. A socio-demographic form was administered, BMD and T-score measurements were performed with a DEXA test, and hormone levels were measured with commercial test kits.
  
  
  RESULTS
  The prolactin levels of the prolactin-raising group (PRG) were significantly higher than those of the healthy control group (CG) and the prolactin-sparing group (PSG). While prolactin levels were normal in the CG, hyperprolactinemia was found in 15.8% (n=3) of patients in the PSG and 65.2% (n=15) of subjects in the PRG. Estradiol levels for the PRG and PSG were similar but significantly lower than those of the CG. There was a statistically significant difference between the PRG, PSG and CG in terms of their L1-4 total actual bone density and T-scores. BMD and T-scores were lower for the PRG in comparison with the PSG and CG, and were consistent with osteopenia. Although not observed for every tested region, a negative correlation was found between age, duration of therapy, duration of illness, and T-scores. A positive correlation was found between subjects BMI and T-scores. A consistent negative correlation was found between total testosterone and L1-4 total T-scores when corrected according to prolactin and estradiol. A linear regression analysis found significant relationships between age, BMI, duration of therapy, duration of illness, chlorpromazine equivalent dose, estradiol and testosterone affected T-scores for some regions.
  
  
  CONCLUSIONS
  The long-term use of prolactin - raising antipsychotic medications as well as hyperprolactinemia and hypoestrogenism accelerate bone degradation.
authors.affiliation: Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Psychiatry, İrfan Baştuğ caddesi No: 12 Dışkapı-Altındağ, Ankara, Turkey, dr_sdbulut@hotmail.com.
authors.forename: Süheyla Doğan
authors.initials: SD
authors.lastname: Bulut
authors.forename: Serdar
authors.initials: S
authors.lastname: Bulut
authors.forename: Dicle Görkem
authors.initials: DG
authors.lastname: Atalan
authors.forename: Rıza Gökçer
authors.initials: RG
authors.lastname: Tulaci
authors.forename: Türker
authors.initials: T
authors.lastname: Türker
authors.forename: Eda
authors.initials: E
authors.lastname: Gürçay
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Aydemir
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000139:chemically induced; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D012016:Reference Values; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D013223:Statistics as Topic; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D012739:Gonadal Steroid Hormones; D013739:Testosterone; D011388:Prolactin