Psychiatria pre prax 5/2006

OSTEOPOROSIS AND SCHIZOPHRENIA

Osteoporosis is a multifactorial disease. Untreated patients with schizophrenia are at risk due to the consequences of the disease related lifestyle factors (nutritional alteration, smoking, polydipsia, lack of physical activity). The etiology of the osteoporosis may be partly explained by the prolacting-raising effect of antipsychotic medication. Hyperprolactinemia itself does not lead to osteoporosis. Decrease of bone mineral density associated with schizophrenia may result from hypogonadism secondary to antipsychotic-induced hyperprolactinemia. The most common clinical signs of hypogonadism is dys/amenorrhea, and galactorrhea in female patients, and sexual dysfunction or gynekomasty in male patients. The prolacting-raising profile of antipsychotic drugs should be considered in treatment plans. Reduction of nicotin abuse and physical activities decrease the risk of osteoporosis in schizophrenic patients.

Keywords: osteoporosis, bone mineral density, schizophrenia, antipsychotics, prolactin.