Logo image
Longitudinal Examination of the Skeletal Effects of Selective Serotonin Reuptake Inhibitors and Risperidone in Boys
Journal article   Open access   Peer reviewed

Longitudinal Examination of the Skeletal Effects of Selective Serotonin Reuptake Inhibitors and Risperidone in Boys

Chadi A. Calarge, Trudy L. Burns, Janet A. Schlechte and Babette S. Zemel
The journal of clinical psychiatry, Vol.76(5), pp.607-613
05/01/2015
DOI: 10.4088/JCP.14m09195
PMCID: PMC6734561
PMID: 26035190
url
https://www.ncbi.nlm.nih.gov/pmc/articles/6734561View
Open Access

Abstract

Objective: In a previous cross-sectional study, we found lower bone mass during treatment with selective serotonin reuptake inhibitors (SSRIs) and risperidone in youths. Here, we evaluate the skeletal effects of these psychotropics at follow-up. Method: Between April 2005 and July 2011, medically healthy 7-to 17-year-old males treated with risperidone for 6 months or more were enrolled through child psychiatry outpatient clinics and returned for follow-up 1.5 years later. Treatment history was extracted from the medical and pharmacy records. Anthropometric, laboratory, and bone mass measurements were obtained. Multivariable linear regression analyses compared participants who remained on risperidone at follow-up to those who had discontinued risperidone treatment as well as SSRI-treated versus SSRI-unexposed participants. Results: The sample consisted of 94 boys with a mean age of 11.8 +/- 2.7 years at study entry. The majority had an externalizing disorder and had received risperidone and SSRIs for 2.5 +/- 1.7 years and 1.6 +/- 1.9 years, respectively, at study entry. By followup, 26% (n = 24) had discontinued risperidone. Compared to discontinuing risperidone, continuing it was associated with a decline in participants' age-sex-height-race-specific areal bone mineral density (BMD) z score at the lumbar spine (P < .04) and failure to increase radius trabecular volumetric BMD (P < .03), after accounting for significant covariates. In addition, receiving an SSRI was associated with reduced lumbar spine areal BMD z score and radius trabecular volumetric BMD at both study entry (P < .02 and P < .03, respectively) and follow-up (P < .06 and P < .03, respectively), but without further decline between the 2 visits. Conclusions: Chronic SSRI treatment in children and adolescents is associated with reduced, albeit stable, bone mass for age, while chronic risperidone treatment is associated with failure to accrue bone mass. (C) Copyright 2015 Physicians Postgraduate Press, Inc.
Life Sciences & Biomedicine Psychiatry Psychology Psychology, Clinical Science & Technology Social Sciences

Details

Logo image