Another reason to be concerned about the long term effects of antipsychotic drugs is that they may cause hyperprolactinaemia, which as well as causing issues such as gynaecomastia and amenorrhea may also contribute to bone loss. The effect of antipsychotics, particularly risperidone, on osteoporosis-related fractures has been recently investigated in a study from Sweden. The nationwide cohort study spanned from 2006-2013 and included adults with two consecutive dispensings within three months of risperidone (n = 38,211), other atypical antipsychotics excluding paliperidone (n = 60,691) or typical (first generation) antipsychotics (n = 17,445). The mean age of those treated with for risperidone, other atypical antipsychotics and typical antipsychotics were 68, 44 and 63 years respectively. In comparison to other atypical antipsychotics, no link was found between risperidone and osteoporosis-related fractures (hazard ratio (HR) = 1.04, 95% CI: 0.91–1.19), but a significantly higher risk was found with typical antipsychotics in ages >45 years (hazard ratio (HR) = 1.04, 95% CI: 0.91–1.19). The researchers conclude that risperidone, previously known to increase serum prolactin levels which may contribute to osteoporosis-related fractures, was not associated with an increased risk of the condition in this study. The original research can be viewed here.

Contributed by Australian Medication Safety Services Associate – Isabella Singh