Antipsychotic medication use in association with quantitative heel ultrasound (QUS)

Behnaz Azimi Manavi; Mohammadreza Mohebbi; Amanda L Stuart; Julie A Pasco; Jason M Hodge; D Kavindi Weerasinghe; Rasika M Samarasinghe; Lana J Williams

doi:10.1016/j.bonr.2023.101694

Antipsychotic medication use in association with quantitative heel ultrasound (QUS)

Bone Rep. 2023 Jun 8:18:101694. doi: 10.1016/j.bonr.2023.101694. eCollection 2023 Jun.

Authors

Behnaz Azimi Manavi¹, Mohammadreza Mohebbi¹, Amanda L Stuart¹, Julie A Pasco^{1

2

3

4}, Jason M Hodge^{1

2}, D Kavindi Weerasinghe¹, Rasika M Samarasinghe¹, Lana J Williams^{1

2}

Affiliations

¹ Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia.
² Barwon Health, Geelong 3220, Australia.
³ Department of Medicine-Western Health, The University of Melbourne, St Albans 3021, Australia.
⁴ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne 3004, Australia.

Abstract

Purpose: Antipsychotic medication use has been associated with decreased bone mineral density; however, less is known whether antipsychotics affect other parameters of bone health. Therefore, the aim of this study was to investigate the association between antipsychotic medication use and quantitative heel ultrasound (QUS) in a population based sample of men and women.

Methods: Thirty-one antipsychotic users and 155 non-users matched for age and sex were drawn from the Geelong Osteoporosis Study. QUS was undertaken and included the parameters: Broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI). Current medication use, lifestyle factors, anthropometry and socio-economic status were collected. Generalized Estimation Equation models were conducted to determine associations between antipsychotic medication use and each of the QUS parameters, adjusting for covariates.

Results: Antipsychotic users were less active, consumed less alcohol, were more likely to smoke and take antidepressants; otherwise, the groups were similar. After adjusting for age, sex and weight, antipsychotic users had a 7.7 % lower mean BUA [108.70 (95 % CI 104.26-113.14) vs. 116.42 (95 % CI 115.48-117.37) dB/MHz, p = 0.005] and 7.4 % lower mean SI [89.92 (95 % CI 86.89-92.95) vs. 97.30 (95 % CI 96.48-98.12) %, p < 0.001] compared to non-users. Differences in mean SOS between antipsychotic users and non-users failed to reach statistical significance (p = 0.07).

Conclusion: Antipsychotic use was associated with lower QUS parameters. The risk of bone deterioration should be considered when antipsychotics are prescribed.

Keywords: Antipsychotic agents; Bone; Bone density; Osteoporosis; Quantitative heel ultrasound.