The impact of prolactin-raising antipsychotics on bone mineral density in patients with schizophrenia: Findings from a longitudinal observational cohort

To examine the effect of prolactin-raising antipsychotics on bone mineral density (BMD), data of 164 schizophrenia patients who received ≥ 2 dual-energy x-ray absorptiometry scans were analyzed (49.3% men; mean ± SD age: 58.5 ± 11.0 years; duration of treatment: 26.7 ± 13.8 years). Patients were divided into a prolactin-raising antipsychotic (n = 141) or prolactin-sparing (n = 23) group, and time x group interaction was examined using mixed effect model. Although the BMD difference did not reach significance over 3.4 ± 1.6 years, a significant antipsychotic-class vs. time interaction was found (p = 0.011), indicating a negative impact of prolactin-raising antipsychotics on BMD. Large-scale, randomized-controlled data are required to replicate and extend these findings.