Psychotropic medications are among the most highly prescribed agents, particularly antidepressants and anxiolytics. Some psychotropic medications have been associated with osteoporosis and increased fracture risk, independent of the mental health disorders they are used to treat. A primary search retrieved 257 articles which were reviewed for relevance to the current topic. This narrative review is based upon relevant articles identified through this search and secondary search of their associated references. Most evidence supports selective serotonin reuptake inhibitors, but not other antidepressant medications, having a negative impact on bone mineral density measurements. Hyperprolactinemia during treatment with prolactin-raising antipsychotic drugs may lead to low bone mass through inhibition of the hypothalamo-pituitary-gonadal axis. Lithium carbonate may be beneficial for bone maintenance and fracture healing. For medications that are sedating or have orthostatic effects, falls are important and potentially modifiable mediating risk factors for fracture.