Indicators of bone metabolism in patients of psychiatric clinic on the background of dimephosphone intake

Aim. To study the indicators of bone metabolism in patients of psychiatric clinics on the background of dimephosphone oral intake.

Methods. Research was conducted at the Republican Clinical Psychiatric Hospital named after V.M. Bekhterev (Kazan). 64 patients (36 men and 28 women) aged 45 to 68 years (mean age 56.8±6.9 years) with various forms of mental disorders taking psychotropic drugs for the period of 3 years and over were examined. Resorption markers were determined - D-pyridinoline in urine, serum tartrate-resistant acid phosphatase, alkaline phosphatase, and the content of total and ionized serum calcium. All patients were divided into two groups: those who received dimephosphone in the combined systemic therapy and those who did not. The average duration of the dimephosphone administration was 22±4.2 days, the patients undergone on average 2.6±1.44 courses of treatment during 6 months.

Results. The activity of tartrate-resistant acid phosphatase in psychiatric patients was higher compared with those of the control group. The maximum value was registered in patients who were not taking dimephosphone. The alkaline phosphatase activity was the highest in mentally healthy patients of the control group. In psychiatric patients treated with dimephosphone, alkaline phosphatase activity was 20% lower compared with the control group. The minimum values of alkaline phosphatase were registered in patients with mental disorders not taking dimephosphone. When studying the concentration of total and ionized serum calcium there were no significant differences between patients of comparison group and psychiatric patients.

Conclusion. Shift in processes of bone remodeling toward its resorption indicates a high risk of pathological fractures in psychiatric patients and the need for osteoporosis prevention; identified changes in biochemical markers of osteoporosis on the background of dimephosphone intake allow to recommend it for the treatment of diagnosed osteoporosis in a psychiatric hospital settings.