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What is osteoporosis?

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?

Moderate quality evidence suggests a medium-sized increased risk of fractures in older veterans with bipolar disorder who were taking anticonvulsants, compared to people without a psychiatric disorder. This result held after adjusting for age, sex, race, marital status, and diagnosis. Review authors report that other factors that were not controlled for (e.g. diet) may account for the findings.

Low quality evidence is unable to determine the effects of valproate in premenopausal females with bipolar disorder on osteoporosis or bone mineral density.

April 2019

Last updated at: 4:55 am, 7th May 2019
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Fact Sheet Technical Commentary

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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.