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Some Antidepressants Increase Risk of Fractures

Some antidepressants may increase the risk of bone fractures in older adults, say researchers.

The use of selective serotonin reuptake inhibitors (SSRIs), a popular type of antidepressant, may increase the risk of a fracture in patients over the age of 50. This may prove to be a very significant connection since approximately 10 percent of the U.S population over the age of 50 suffers from depression, and this segment of the population is at an increased risk of fracture from a slip or fall.

“Depression and fragility fractures are common in this age group, and the elevated risk attributed to daily SSRI use may have important public health consequences,” said Dr. David Goltzman and colleagues in the study, published in the Archives of Internal Medicine.

For the study, Goltzman and colleagues looked at 137 patients ages 50 and older, who were using SSRIs. The participants charted how frequently they used these drugs, and over the course of five years, the participants were also sent questionnaires asking about any fractures that may have occurred from a minor fall or injury.

From the data, it was determined that daily use of SSRIs increased the risk of sustaining a fracture from a minor fall. Additionally, the greater the dose of SSRI the patient took, the greater this risk rose. In fact, doubling the base dose of an SSRI seemed to increase the risk of a fracture one-and-a-half times.

To figure out why SSRIs increase fracture risk, the researchers performed bone mineral density tests, a routine check of bone strength, on the participants. Those who used SSRIs daily had a 4 percent lower bone density in their hip than those who did not use the drug that frequently.

“Part of it is a reduction in the quality of bone, and some of it is a reduction in the quantity of bone,” said Goltzman.

Goltzman believes that SSRIs block receptors that are responsible for the effective creation of new bone. However, those who use SSRIs shouldn’t stop taking them.

“We are not advising people to stop taking SSRIs,” said Goltzman. “But both physicians and patients should be aware of this increased risk.”

Goltzman recommends that patients who are taking SSRIs maintain an active lifestyle: physical activity, consuming enough calcium and quitting smoking have all been shown to reduce the risk of fracture. Additionally, he suggests, seniors taking SSRIs should have bone mineral density tests taken at regular intervals to monitor for any potential problems.