Antipsychotic Medication in Schizophrenic Patients is Associated with Higher Risks of Developing Bone Fractures and Refractures

Ching-Min Kuo; Wei-Jen Liao; Chun-Che Huang; Tsuo-Hung Lan; Ching-Heng Lin; Shun-Ping Wang; Cheng-Hung Lee; Ping-Wing Lui

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자료유형: 학술저널

저자정보: Ching-Min Kuo (Taichung Veterans General Hospital) Wei-Jen Liao (Taichung Veterans General Hospital) Chun-Che Huang (Taichung Veterans General Hospital) Tsuo-Hung Lan (Taichung Veterans General Hospital) Ching-Heng Lin (Taichung Veterans General Hospital) Shun-Ping Wang (Taichung Veterans General Hospital) Cheng-Hung Lee (Taichung Veterans General Hospital) Ping-Wing Lui (Taichung Veterans General Hospital)

저널정보: 대한정신약물학회 Clinical Psychopharmacology and Neuroscience Clinical Psychopharmacology and Neuroscience 제18권 제4호

발행연도: 2020.1

수록면: 562 - 570 (9page)

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Objective: The relationship of antipsychotics and the risk of refracture in treated patients is unclear. The aim of this study is to evaluate the association between prolonged antipsychotic and the incidences of bone fractures and refractures in schizophrenia. Methods: This is a retrospective nested case-control study using Taiwan National Health Insurance Research Database recorded from 2000 to 2005, with cases followed up to end of 2011. Total of 7,842 schizophrenic patients, 3,955 had developed bone fractures were compared with 3,887 control subjects matched in age, sex, and index date. Antipsychotic drug exposure was classified based on the drug type and medication duration. Conditional logistic regression analyses were performed. Odds ratio (OR) and confidence interval (CI) were calculated. Results: We found (after adjustments) higher risks of developing fractures under continued use of typical (OR = 1.70; 95% CI, 1.51?1.91) or atypical antipsychotics (OR = 1.43; 95% CI, 1.28?1.60) were found. Additionally, continued use typical (OR = 1.84; 95% CI, 1.35?2.50) or atypical antipsychotics (OR = 1.44; 95% CI, 1.06?1.95) was positively associated with refracture risks. Moreover, refractures were associated with continuous use of chlorpromazine (one typical antipsychotics, OR = 2.45; 95% CI, 1.14?5.25), and risperidone (OR = 1.48; 95% CI, 1.01?2.16) or zotepine (OR = 2.15; 95% CI, 1.06?4.36) (two atypical antipsychotics). Conclusion: Higher risks of bone fracture and refracture were found in schizophrenia under prolonged medication with typical or atypical antipsychotics. We therefore recommend that clinicians should pay more attention on bone density monitoring for patients using long-term antipsychotics.

#Antipsychotic agents #Fracture #Refracture #Schizophrenia.

참고문헌 (20)

참고문헌 신청

McGrath J / 2008 / Schizophrenia: a concise overview of incidence, prevalence, and mortality / Epidemiol Rev 30:67~76

Kahn RS / 2015 / Schizophrenia / Nat Rev Dis Primers 1:15067

Yang YH / 2018 / Prevalences of schizophrenia, bipolar disorder, and depressive disorders in community between Taiwan and other countries / Taiwan J Psychiatry 26:77~87

Kishimoto T / 2012 / Osteoporosis and fracture risk in people with schizophrenia / Curr Opin Psychiatry 25:415~429

Fleischhacker WW / 1994 / Compliance with antipsychotic drug treatment: influence of side effects / Acta Psychiatr Scand Suppl 382:11~15

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