Osteoporosis

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Departments of Internal Medicine & Psychiatry, Yale University School of Medicine, New Haven, CT, USA

Osteoporosis is a condition of low bone mass. The prevalence increases with age and postmenopausal status in women. In both men and women, low physical activity, decreased calcium and vitamin D intake, cigarette smoking, and alcohol consumption are all risk factors. It can occur secondarily due to systemic illnesses. The main clinical impact of osteoporosis is increased risk for fractures.

Psychotropic Medications and Osteoporosis

Risk of osteoporosis appears to be increased in patients on selective serotonergic reuptake inhibitors (SSRIs) . The risk starts in the first few months of treatment and diminishes about a year after stopping the medication. Tricyclic antidepressants (TCAs) also increase the risk [1]. The mechanism is thought to be via serotonergic receptors in bone cells. Anticonvulsant medications also affect bone density by effects on vitamin D, parathyroid hormone, and calcitonin metabolism. Antipsychotics affect bone density by elevating prolactin levels.

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