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Long Term Use of Antipsychotics and Adverse Effects on Bone Density

Author(s): Ahmed Rady, Adel Elsheshai, Osama Elkholy, Heba Abouelwafa, Mohamed Eltawil

Background and Objectives

High incidence of osteoporosis and pathological fractures were observed in schizophrenic patients medicated by antipsychotics for long time. Hyperprolactinemia induced by antipsychotics may partially contribute to osteopenia. Though atypical antipsychotics cause less hyperprolactinemia than conventional antipsychotics, however, risperidone and amisulpride seem to have no advantage in this regard. Our study aims at assessing effect of long term use of antipsychotics on bone density.


30 schizophrenic patients on antipsychotics for 2-10 yrs were recruited compared to control drug naïf schizophrenic group for bone mineral density Results: both groups were balanced for age and gender distribution. Significantly decreased bone mineral density was found among schizophrenic patients on long term use of antipsychotics (X2=3.25;p<0.05). This later had significantly higher serum prolactin (p<0.001) and lesser serum cortisol level (p<0.01).


Osteopenia and osteoporosis are common adverse effects among antipsychotics, though can easily be screened for, but it’s often a forgotten side effect with impact on general health state.

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