Antipsychotic use and fracture risk: An evaluation of incidence at a Veterans Affairs medical center
Abstract
Introduction Recent meta-analyses have found a correlation between schizophrenia and increased fracture risk with one contributing factor potentially being antipsychotic-induced hyperprolactinemia, which may accelerate bone turnover. The objective of this study is to evaluate fracture rates in patients on long-term antipsychotic therapy to see if screening for osteoporosis should be included with routine monitoring. Methods Patients exposed to antipsychotics for ≥3 months during a 10-year study period were included in this retrospective analysis. The primary outcome was to compare fracture rates in those exposed to long-term antipsychotics to a control group with similar demographics and comorbidities not receiving antipsychotics. Secondary outcomes included examining the risk of fracture by medication use and comorbid disease states associated with causing osteoporosis, vitamin D level monitoring and fracture presence, and the time to first fracture. Results Long-term use of antipsychotics was not associated with an increased rate of fractures compared to the control group in this study. End-stage renal disease, tobacco use, alcohol use, glucocorticoids, antiepileptics, and proton pump inhibitors were associated with higher risk of fracture (P < .05). Vitamin D level monitoring and supplementation was found to be a protective factor and lowered the risk of fracture. Discussion Long-term antipsychotic use is not associated with an increased risk of fractures. Further…
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