|
1
|
Azimi Manavi B, Stuart AL, Pasco JA, Hodge JM, Weerasinghe DK, Samarasinghe RM, Williams LJ. Antipsychotic medication use and fracture: a case-control study. Sci Rep 2023; 13:13709. [PMID: 37608079 PMCID: PMC10444797 DOI: 10.1038/s41598-023-40762-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 08/16/2023] [Indexed: 08/24/2023] Open
Abstract
It has been reported that antipsychotic use is associated with lower bone mineral density and bone quality. We aimed to determine whether antipsychotic use is associated with fracture risk in a population-based sample of adults living in the Barwon Statistical Division, south-eastern Australia. In this case-control study, 1458 participants (51.8% women) with radiologically confirmed fracture between June 1st 2012 and May 31st 2013 (cases) were compared with 1795 participants (46.5% women) without fracture (controls) for the same time period. Medication use, medical history and lifestyle factors were documented by self-report. Multivariable binary logistic regression was used to explore associations between antipsychotic use and fracture following adjustment for possible confounders. In women, antipsychotic use was identified for 20 of 755 (2.6%) cases and 10 of 834 (1.2%) controls (p = 0.034) and in men, antipsychotic use was identified for 13 of 703 (1.8%) cases and 5 of 961 (0.5%) controls (p = 0.010). Following adjustments, antipsychotic use was associated with a 3.0-fold increased risk of fracture in men and a 2.3-fold increased risk of fracture in women. Patterns persisted after exclusion of participants with non-fragility fractures and self-reported schizophrenia. While future research exploring underlying mechanisms is needed, regular monitoring of bone health in antipsychotic users is suggested.
Collapse
Affiliation(s)
- Behnaz Azimi Manavi
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia.
| | - Amanda L Stuart
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
| | - Julie A Pasco
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
- Barwon Health, Geelong, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, 3021, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Jason M Hodge
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
- Barwon Health, Geelong, 3220, Australia
| | - D Kavindi Weerasinghe
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
| | - Rasika M Samarasinghe
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
| | - Lana J Williams
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
- Barwon Health, Geelong, 3220, Australia
| |
Collapse
|
|
2
|
Chandrasekaran V, Stuart AL, Pasco JA, Brennan-Olsen SL, Berk M, Hodge JM, Samarasinghe RM, Williams LJ. Anticonvulsant use and fracture: a case-control study. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:422-428. [PMID: 34465682 PMCID: PMC8426646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES We aimed to investigate fracture risk associated with anticonvulsant use in a population-based sample of men and women. METHODS Data from 1,458 participants (51.8% women) with a radiologically confirmed incident fracture (cases) were compared to 1,796 participants (46.5% women) without fracture (controls). Lifestyle factors, medication use and medical history were self-reported. Associations between anticonvulsant use and fracture were explored using binary logistic regression following adjustment for confounders. RESULTS In men, fracture cases and controls differed in age, smoking history, education, alcohol use, and gonadal hormone supplementation. In women, fracture cases and controls differed by previous fracture history, alcohol use, physical activity levels and use of anti-fracture agents. After adjustment for age, pooled anticonvulsant use was associated with a 3.4-fold higher risk of fracture in men and a 1.8-fold higher risk in women. Following further adjustments for confounders these patterns persisted; a 2.8-fold higher fracture risk in men and a 1.8-fold higher fracture risk in women. CONCLUSIONS Anticonvulsant use was associated with increased fracture risk, independent of demographic, lifestyle, medical and medication related factors. While further studies exploring potential underlying mechanisms are warranted, regular monitoring of bone health in anticonvulsant users with risk factors may be useful.
Collapse
Affiliation(s)
- Vinoomika Chandrasekaran
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia,Corresponding author: Vinoomika Chandrasekaran, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University Kitchener House, PO Box 281 (Barwon Health) Geelong, VIC 3220, Australia E-mail:
| | - Amanda L. Stuart
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Julie A. Pasco
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia,Barwon Health, University Hospital, Geelong, Australia,Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sharon L. Brennan-Olsen
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia,Deakin University, School of Health and Social Development, Geelong Waterfront, Australia,Institute for Health Transformation, Deakin University, Burwood, Australia
| | - Michael Berk
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia,Barwon Health, University Hospital, Geelong, Australia,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia,Department of Psychiatry, University of Melbourne, Parkville, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, Australia,Orygen the National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Jason M. Hodge
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia,Orygen the National Centre of Excellence in Youth Mental Health, Parkville, Australia,Geelong Centre for Emerging Infectious Diseases, Geelong, Australia
| | - Rasika M. Samarasinghe
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Lana J. Williams
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| |
Collapse
|