Schizophrenia and osteoporosis

Although it has been suggested that antipsychotic-induced hyperprolactinaemia in schizophrenic patients may lead to an increased risk of osteoporosis, this has not been proven. Osteoporosis is a multifactorial disease, and untreated patients with schizophrenia are at risk due to both the consequences of the disease and related lifestyle factors. Evidence from available studies does not show that anti psychotic-induced hyperprolactinaemia is an independent risk factor for osteoporosis in schizophrenic patients. Osteoporosis would be expected in women who develop amenorrhoea as a result of hyperprolactinaernia secondary to antipsychotics, but there is no plausible mechanism in men. The uncertainty over this issue underlines the need for full medical and metabolic assessment and monitoring of psychiatric patients. (C) 2004 Lippincott Williams Wilkins.