What is osteoporosis in bipolar disorder?

Osteoporosis is a progressive, systemic metabolic bone disorder, which results in lowered bone mineral density and increases an individual’s risk of fracture. Between ages 25 to 35 years, the skeletal structure reaches maturity and bone mass reaches its peak. After 40 years, the bone remodeling process serves to repair areas of damage in the bone. Naturally with increasing age and menopause, the process of bone resorption may be faster than the process of bone formation, leading to osteoporosis. However, other diseases and drugs may also induce osteoporosis. Many people with bipolar disorder are prescribed medications that can cause hyperprolactinemia, which inhibits the amount of estrogen and testosterone secreted by the brain, and in turn can increase the risk of osteoporosis.

What is the evidence for osteoporosis in bipolar disorder?

High quality evidence finds a small increased risk of fractures in people with bipolar disorder after adjusting for possible explanatory variables including age, sex, comorbidities, medications, race, marital status, and substance use. Low quality evidence is unable to determine the effects of valproate in premenopausal females for osteoporosis or bone mineral density.

October 2021

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Last updated at: 12:43 am, 26th October 2021
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