Long-term second-generation antipsychotics decreases bone formation and resorption in male patients with schizophrenia.

Rationale: Patients with schizophrenia with second-generation antipsychotics (SGAs) treatment have shown an increased risk of bone fragility and susceptibility to fracture; however, it is still unclear whether this risk is derived from the effect of antipsychotics on balance of bone metabolism. Objectives: We investigated the changes of two bone turnover biomarkers (BTMs) concentrations in people with schizophrenia receiving SGAs: procollagen type I aminoterminal propeptide (PINP) and C-terminal telopeptide of type I collagen (CTX-1) as BTMs of osteogenesis and bone resorption, respectively, to explore how antipsychotics contribute to bone fragility. Methods: We recruited 59 Chinese male patients with schizophrenia (32 drug-naïve first-episode (DNFE) patients and 27 chronic patients) to undergo 8 weeks SGAs treatment. Fasting peripheral blood samples of pre- and posttreatment were collected, plasma levels of PINP and CTX-1 were measured. Results: The interaction effects of group and time on PINP and CTX-1 concentrations were found (P =.016 and P =.008). There was a significant decrease for both BTMs concentrations of the posttreatment compared to the pretreatment (P<.001 and P =.003). Chronic patients had significantly higher changes of BTMs concentrations compared to DNFE patients (P =.048 and P =.024). There was a positive correlation of the two BTMs of pretreatment with disease course in DNFE group (r =.37, P =.039;r =.38, P =.035) and a negative correlation of PINP of pretreatment with age in the chronic group (r=-.40, P =.039). Conclusion: Long-term SGAs medication inhibited osteogenesis in a dose- and time-dependent manner and damaged the balance of bone formation and bone resorption. [ABSTRACT FROM AUTHOR]