Neuropsychiatric Disorders and the Skeleton

It is now well established that some neuropsychiatric diseases, mainly major depressive disorder (MDD), anorexia nervosa (AN), and traumatic brain injury (TBI) are associated with changes in bone mass. Initial indications suggest that schizophrenia and Alzheimer's disease (AD) are accompanied by changes in bone density. A number of first-line agents used in the treatment of neuropsychiatric disorders are associated with low BMD and increased fracture risk, potentially amplifying the negative impact of these disorders on the skeleton. The most urgent unresolved clinical issue is the conflict between the beneficial effects of psychiatric medications, particularly in mood disorders and schizophrenia, and the deleterious effects of the very same medications on the skeleton.