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There is growing evidence that chronic hyperprolactinemia from antipsychotics can cause osteoporosis and an increased risk of hip fracture. A recent case-control analysis of a large general practice database in the United Kingdom showed that the risk of hip fracture was times higher in patients taking prolactin-raising antipsychotics compared with the general population. 20 Physicians should routinely inquire about symptoms that might reflect hyperprolactinemia in patients taking prolactin-raising antipsychotics and, if present, measure the serum prolactin level. Presence of osteoporosis, sexual side effects, or prolactin-dependent breast cancer may necessitate switching to an antipsychotic that does not raise prolactin levels, such as aripiprazole (Abilify) or quetiapine. 21