In other longitudinal studies, Abraham and colleagues did not find a

relationship between prolactin elevation and BMD in women over the course of 1 year of treatment with risperidone or olanzapine [Abraham et al. 2003b]. However, those with prolactin elevation did have higher rates of bone resorption over the course of the study, indicating that a longer timeframe was likely needed to observe the resulting effects on BMD. More recently, evidence was observed Inhibitors,research,lifescience,medical that in premenopausal women, treatment for 1 year with prolactin-raising antipsychotics such as risperidone, sulpride, amisulpride, or depot first-generation antipsychotics reduced lumbar BMD compared with patients Inhibitors,research,lifescience,medical treated with the prolactin-sparing agent olanzapine [Meaney and O’Keane, 2007]. The findings presented herein need to be interpreted in the context of certain selleck chemicals llc limitations of the study. The study sample examined here is too small to clearly delineate sex differences in relationships

between hormone markers and bone turnover. Inhibitors,research,lifescience,medical Additionally, our lack of controls and small sample size increases the risk for type 1 and type 2 errors. The flexible dosing strategy employed, while representative of typical clinical practice, likely increased the variability observed in some of the outcomes, but similarly allowed us to gain insight into potentially important effects to examine in future studies. It is unknown whether any of the antipsychotic-associated changes observed here differ based on diagnosis. We were not powered to detect effects by diagnostic category. However, an exploratory post hoc analysis did not identify evidence for differences across diagnostic groups. Other modifying factors Inhibitors,research,lifescience,medical may also influence bone homeostasis in patients requiring treatment with antipsychotic agents. These include biological and environmental variables such as diet, smoking, and exercise [Halbreich and Palter, 1996]. We did not examine diet or exercise in these participants but an examination of smoking status (data not shown) Inhibitors,research,lifescience,medical did not reveal evidence for associations with bone markers

before or after treatment. Finally, this was an acute study examining short-term drug exposure on selected blood-based biomarkers related to bone homeostasis. There are also no other biomarkers beyond NTx and osteocalcin not assessed in this study that may be informative for identifying drug-related effects on bone metabolism. It is unclear how these short-term effects translated into longer-term outcomes. In longer-term studies researchers often use DEXA scans as a gold standard for assessing bone density changes over extended periods of time and it will be informative to conduct subsequent studies examining the relationships between blood biomarkers of bone metabolism and bone density from imaging studies.