The Impact of Psychotropic Medications on Bone Health in Youth

Curr Psychiatry Rep. 2018 Sep 24;20(11):104. doi: 10.1007/s11920-018-0960-5.

Abstract

Purpose of review: Psychotropics are prescribed to youth at rapidly growing rates and may negatively impact bone health. Little awareness exists of this association among prescribing providers. Childhood and adolescence are critical times for bone development. Understanding these effects and their management is important to informed psychotropic use.

Recent findings: Through a variety of mechanisms, antidepressants, benzodiazepines, mood stabilizers, neuroleptics, and stimulants may all negatively impact pediatric bone health. This confers added risk of osteoporosis in a population already at high risk for suboptimal bone health. Awareness of psychotropic-mediated effects on pediatric bone development is clinically relevant to the use and monitoring of these agents. Clinicians can manage these effects through informed consent, vitamin D supplementation, lifestyle modifications, and reducing polypharmacy. For mood stabilizers, vitamin D level monitoring and secondary prevention is indicated. Future longitudinal studies and development of monitoring guidelines regarding psychotropic impact on bone health are necessary.

Keywords: Bone; Medication; Mineral density; Pediatric; Psychotropic; Side effect; Vitamin D; Youth.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Anticonvulsants / pharmacology
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use
  • Antimanic Agents / pharmacology
  • Antimanic Agents / therapeutic use
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use
  • Benzodiazepines / pharmacology
  • Benzodiazepines / therapeutic use
  • Bone Density / drug effects*
  • Central Nervous System Stimulants / pharmacology
  • Central Nervous System Stimulants / therapeutic use
  • Child
  • Humans
  • Polypharmacy
  • Psychotropic Drugs / pharmacology*
  • Psychotropic Drugs / therapeutic use*

Substances

  • Anticonvulsants
  • Antidepressive Agents
  • Antimanic Agents
  • Antipsychotic Agents
  • Central Nervous System Stimulants
  • Psychotropic Drugs
  • Benzodiazepines