Risperidone, but not olanzapine, decreases bone mineral densitv in female premenopausal schizophrenia patients
Risperidone, but not olanzapine, decreases bone mineral densitv in female premenopausal schizophrenia patients
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DOI：
10.4088/jcp.v64n0704
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发表时间：
2003-07-01
影响因子：
5.3
通讯作者：
Weiss, M
中科院分区：
文献类型：
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作者：
Becker, D;Liver, O;Weiss, M
背景：传统抗精神病药物引起的高催乳素血症常导致骨质疏松。常用的非典型抗精神病药物利培酮和奥氮平的高催乳素特性各不相同。因此，我们比较了接受利培酮或奥氮平治疗的女性绝经前精神分裂症患者的激素谱和骨性能。方法：在一项横断面研究中，连续接受利培酮(12例)或奥氮平(14例)治疗至少2年的绝经前女性DSM-IV精神分裂症患者包括在内。双能X线骨密度仪测定骨密度，多点定量超声测定骨声速。结果：利培酮组血清催乳素水平高于奥氮平组(123 144和25.9+/-25.7，p<；0.05)。虽然治疗组骨密度相似，但利培酮组的骨声速低于奥氮平组。以年龄调整的Z分数表示，骨声速在桡骨分别为-0.31和0.58，p<；0.05；在指骨，分别为-1.41和0.04，p<；0.05。利培酮治疗的女性绝经前精神分裂症患者的骨声速值与尿脱氧吡啶酚排泄量呈负相关(r=0.73，p<；0.05)。结论：与奥氮平相比，利培酮治疗绝经前女性精神分裂症可导致高催乳素血症和临床相关的骨密度下降。使用利培酮治疗的女性与使用奥氮平治疗的女性相比，计算出的脆性骨折的相对风险在指骨测量声速时为1.78，在桡骨测量时为1.23。
Background: The hyperprolactinemia induced by conventional antipsychotics often leads to osteoporosis. The commonly used atypical antipsychotics risperidone and olanzapine vary in their hyperprolactinemic properties. Therefore, we compared hormone profiles and bone properties in female premenopausal schizophrenia patients treated with either risperidone or olanzapine.Method: In a cross-sectional study, consecutive premenopausal, female, DSM-IV schizophrenia patients who were treated with either risperidone (N = 12) or olanzapine (N = 14) for at least 2 years were included. Dual energy X-ray absorptiometry evaluated bone mineral density, and multisite quantitative ultrasound measured bone speed of sound. In addition, profiles of urinary excretion of deoxypyridinoline and circulating levels of hormones and lipids were assessed.Results: Serum prolactin levels were higher in the risperidone-treated group as compared with the olanzapine subjects (123 144 and 25.9 +/- 25.7, p < .05). Whereas bone mineral density was similar in the treatment groups, bone speed of sound was lower in the risperidone group as compared with the olanzapine-treated group. Expressed as age-adjusted Z score, bone speed of sound at the radius was -0.31 and 0.58, respectively, p < .05, and at the phalanx, -1.41 and 0.04, respectively, p < .05. The bone speed of sound in the risperidone-treated patients inversely correlated with urinary deoxypyridinoline excretion (r = 0.73, p < .05).Conclusion: Risperidone treatment, as opposed to olanzapine, for female premenopausal schizophrenia results in hyperprolactinemia and clinically relevant decrease in bone mineral density. The calculated relative risk for fragility fracture of women treated with risperidone as compared to those treated with olanzapine is 1.78 when bone speed of sound was measured at the phalanx and 1.23 when measured at the radius.