Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 26, 2026 56 minutes ago
A new Thai study examining women with schizophrenia who take antipsychotic medicines that can raise prolactin has produced an unexpected finding: a higher prolactin level measured at one point in time was not independently linked to poorer bone mineral density.
Among women taking prolactin-raising antipsychotics, physical activity showed a stronger and more consistent association
with bone density than a single prolactin measurement
Why Prolactin and Bone Health Matter
Some antipsychotic medicines block dopamine signals and can increase prolactin, a hormone best known for its role in breast milk production.
Persistently high prolactin can interfere with reproductive hormones, including estrogen, creating concern that long-term elevations could weaken bones and raise fracture risk.
The study involved 68 women with schizophrenia. Nearly 88% were taking risperidone.
Blood tests measured prolactin, while DXA scans assessed bone mineral density at the lumbar spine, femoral neck and total hip.
The researchers used Z-scores, which compare a person's bone density with what is expected for people of the same age and sex.
Key Findings Challenge a Simple Prolactin-Bone Link
Median prolactin was 44.51 ng/mL. Yet statistical analyses found no significant independent relationship between prolactin and bone density at any of the three measured sites, even after accounting for age, body mass index, duration of antipsychotic exposure, medication dose and physical activity.
This Medical News report highlights that physical activity showed the clearest and most consistent relationship with bone health. Women reporting at least one physical-activity session per week had significantly higher adjusted bone-density Z-scores at the spine, femoral neck and total hip.
Higher BMI was also associated with higher bone-density Z-scores at the femoral neck and total hip, although the investigators cautioned that obesity should not automatically be considered protective because very high body weight can bring other health and fracture risks.
A separate analysis involving only the 60 women taking risperidone produced the same result: prolactin was still not significantly associated with bone density at any measured site.
What the Results Do—and Do Not—Mean
The findings do not prove that chronically high prolactin is harmless to bones. The study measured prolactin only once and cannot show how long participants had experienced elevated levels. Bone changes can develop gradually, while prolactin can rise relatively quickly after antipsychotic treatment begins.
The study was also smaller than planned: 68 women were analyzed although 84 had been estimated as necessary. Hormone levels, vitamin D, calcium intake and bone-turnover markers were not systematically available.
The study involved
Thailand Medical researchers from the Prasrimahabhodi Psychiatric Hospital and th
e Faculty of Pharmaceutical Sciences at Ubon Ratchathani University, both in Thailand.
Conclusions
The results suggest bone health in women receiving prolactin-raising antipsychotics is shaped by multiple factors, not simply one prolactin reading. Larger long-term studies tracking hormones, nutrition, exercise, repeated prolactin measurements and bone changes are needed before firm clinical conclusions can be made.
The study findings were published in the peer reviewed journal:
Pharmacoepidemiology.
https://www.mdpi.com/2813-0618/5/3/31
Read Also:
https://www.thailandmedical.news/articles/thailand-medical
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