Changes in biomarkers of bone turnover in an aripiprazole add-on or switching study

Lodhi, Rohit J.; Masand, S; Malik, Aneela Younas; Shivakumar, Kuppuswami; McAllister, Victoria; O’Keane, Veronica; Young, Leah C.; Heald, Adrian; Sherwood, Roy; Aitchison, Katherine J.

doi:10.1016/j.schres.2015.12.007

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…Low bone mineral density and an increased risk of fractures, possibly mediated by hyperprolactinaemia, have been reported in patients taking antipsychotic drugs (Crews 2012; Wu 2013). The degree of bone loss is related to the degree and duration of hypogonadism; moreover, restoring prolactin levels can partially reverse the loss of bone mass (O'Keane 2008; Lodhi 2016).…”

Section: Hyperprolactinaemiamentioning

confidence: 99%

Management of antipsychotic-induced hyperprolactinaemia

Gupta¹,

Lakshmanan²,

Khastgir³

et al. 2017

BJPsych advances

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SummaryHyperprolactinaemia is a common endocrine disorder that can be associated with significant morbidity. Antipsychotic medications are frequently linked to hyperprolactinaemia. This disorder usually presents as menstrual problems in women and sexual problems in men, which affect the patients' quality of life and adherence to antipsychotic treatment. In the past, treatment for hyperprolactinaemia was recommended only for symptomatic patients. However, it has become clear that persistent asymptomatic hyperprolactinaemia can be associated with long-term physical morbidities such as osteoporosis and possibly breast cancer. Hence, it is imperative that hyperprolactinaemia is managed even if asymptomatic when initially detected. This article discusses the various management options, such as reducing the dose of antipsychotic medication, switching to a prolactin-sparing antipsychotic and adding aripiprazole to the treatment regimen.Learning Objectives• Understand the physiology of the prolactin hormone• Be able to judge when to intervene if a patient on an antipsychotic medication presents with hyperprolactinaemia• Learn about the different treatment options

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Section: Hyperprolactinaemiamentioning

confidence: 99%

Management of antipsychotic-induced hyperprolactinaemia

Gupta¹,

Lakshmanan²,

Khastgir³

et al. 2017

BJPsych advances

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“…On the other hand, BSAP levels were significantly reduced in both groups of patients, as well as PRL. So it was concluded that aripiprazol shaped better bone metabolism profile (37).…”

Section: Antipsychotic-induced Hyperprolactinaemia and Decrease Bone ...mentioning

confidence: 99%

“…Researchers have also tried to determine if there is a change in bone biomarkers in patients with schizophrenia who were switched or have add-on therapy of atypical antipsychotic aripiprazol (37). Prolactin, estrogen and testosterone, urinary N-Terminal telopeptide (NTX) and serum Bone-Specific Alkaline Phosphatase (BSAP) levels were measured in certain intervals.…”

Section: Antipsychotic-induced Hyperprolactinaemia and Decrease Bone ...mentioning

confidence: 99%

Effects of Antipsychotics on Bone Mineral Density in Schizophrenia

Koricanac¹,

Borovcanin

Lucic

2023

Experimental and Applied Biomedical Research (EABR)

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Previous researches have shown that patients with schizophrenia who were using antipsychotics in their treatment developed changes in Bone Mineral Density and body composition, leading to osteoporosis and modifications in weight, skeletal muscle mass index and percent of fat tissue. Results of many studies suggested that the use of antipsychotic causes hyperprolactinemia and consequently lower bone mineral density values were observed. Further, antipsychotics increase food intake and have possible effects on metabolism, causing changes in weight, glucose level and lipid status, all of which can be a risk for developing metabolic syndrome and result in changing of bone mineral density. Antipsychotics change cytokine profi les in patients with schizophrenia and on the other hand the influence of T cells, B cells and inflammatory cytokines on osteoclasts and on osteoblasts was also established. In assessing the effects of antipsychotic on bone metabolism very important is to consider the duration of the treatment and clinical course of the disease, but undeniable effect is careless life style and inadequate physical activity that patients with schizophrenia have. Our attempt is to give an overview of the newest findings in this field, regarding the direct effects of antipsychotics on the bone metabolism, but also through prolactine elevation, metabolic and immune changes. Better understanding of the underlying mechanisms of schizophrenia and changes in bone mineral density could improve our clinical practice: affect to choice of the individually most appropriate antipsychotic, point to the need to monitor possible immunmetabolic changes during the treatment and improvement of the life quality of this vulnerable population.

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“…2 Adolescents with severe chronic mental health conditions are at higher risk of low vitamin D levels, because of poor diet, limited physical activities, low sun exposure, and high substances comorbidity, and this increases their bone metabolism vulnerability and exaggerates the detrimental effects of APs on the bone mineralization. 6,7 One observational study in schizophrenia points out the correlation of accelerated bone resorption in schizophrenia adult patients on chronic APs to the metabolic changes, where they found elevated serum osteocalcin and β-Cross Laps levels that positively correlated with high insulin, low estradiol level, which might point out to a possible abnormality in glucose and lipid metabolism, and insulin resistance. 7 Children and adolescents with autism spectrum disorder (ASD) may carry a higher risk for skeletal changes for several reasons than other children.…”

Section: Introductionmentioning

confidence: 99%

Review of the Long-Term Effect of the Atypical Antipsychotic Medication on the Bone Mineral Density of the Pediatric Patient with Consideration of Autism Spectrum Disorder

Jumaili

Muzwagi

2022

Journal of Pharmacology and Pharmacotherapeutics

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Objectives: To shed some light on the understudied complication of chronic prolonged exposure to antipsychotics (AP) in children with consideration to with autism spectrum disorder (ASD). Methods: We electronically searched PubMed, Google Scholar, clinical trial.gov, and Medline Database of clinical studies up to June 2021. We used the following keywords: “bone mineral density, osteoporosis, osteopenia, bone loss, bone changes” AND “antipsychotics, SGAs, atypical antipsychotics” AND “pediatric, adolescent, young, youth, children.” We used [Mesh] Term for “antipsychotics agent” and “bone mineral density” and “autism spectrum disorder” and “child.” We retrieved relevant observational studies, reviews, case series, and randomized clinical trials. Results: Yvette Roke et al., in 2012, reported in a retrospective observational study that lumbar spine bone mineral density (BMD) and the biochemical bone marker were lower in the AP-treated boy with hyperprolactinemia in comparison to the non-AP-treated group, while a retrospective observational study of institutional adolescents with a psychiatric condition, carried out by Bonnot et al. in 2011, found significant vitamin D deficiency in psychiatric inpatient adolescents that is unrelated to the specific APs. Third, Calarge et al. in a 2010 retrospective observational study have reported a significant reduction in BMD in adolescents with risperidone-induced hyperprolactinemia and selective serotonin reuptake inhibitor (SSRI) compared to another group with risperidone-induced hyperprolactinemia without SSRI. On the other hand, Nivin A. Nagiub et al. (2019) in the cross-sectional study found no correlation between BMD and AP use in children with ASD. Houghton et al., in 2021, found a high fracture prevalence of 38% with aripiprazole compared to risperidone in children with ASD. Conclusion: Clinicians should be aware of the potential negative effects of APs on BMD, considerably in children with ASD that has additional risk factors for osteoporosis and bone disease. A provider needs to utilize more sensitive screening and diagnostic tools; the pediatric physician should evaluate other risk factors to prevent early osteopenia and bone fracture in children with ASD who are on chronic psychotropic medication, before adjusting to the AP medication.

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Changes in biomarkers of bone turnover in an aripiprazole add-on or switching study

Cited by 7 publications

References 41 publications

Management of antipsychotic-induced hyperprolactinaemia

Management of antipsychotic-induced hyperprolactinaemia

Effects of Antipsychotics on Bone Mineral Density in Schizophrenia

Review of the Long-Term Effect of the Atypical Antipsychotic Medication on the Bone Mineral Density of the Pediatric Patient with Consideration of Autism Spectrum Disorder

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