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Antidepressants Linked to Fragile Bones in Seniors

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A new Canadian study has found a correlation between the use of antidepressants and lower bone strength in elderly patients. The findings pertain to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which includes such popular drugs as Prozac, Zoloft, and Paxil. The results of the study, known as the Canadian Multicentre Osteoporosis Study (CaMos), were published in today’s issue of the Archives of Internal Medicine, a publication of the American Medical Association.

According to researchers at McGill University in Montreal, daily intake of SSRIs may double the risk of bone fractures in individuals aged 50 and older. The group studied 5008 community-dwelling adults and followed them for five years, looking for incident fractures. Of the total cohort, 137 individuals (average age of 65) reported that they used SSRIs on a daily basis.

In the SSRI group, there were 18 fractures out of 137 people, or 13.5 percent, while non-users suffered 317 fractures out of 4,871 people, or 6.5 percent. Daily SSRI use was also associated with a 4 percent decrease of bone density at the hip and a 2.4 percent decrease at the lumbar spine. More surprisingly, daily SSRI usage also appears to double the risk of patients falling. However, researchers controlled for both of these factors.

“Our results suggest that BMD [bone density] and falls may be affected adversely by daily SSRI use, but that fracture rates remain elevated despite adjustment for these two risk factors, indicating that other pathways, such as impaired bone quality leading to reduced bone strength, may be of particular relevance,” the authors conclude. “In light of the high rate of SSRI use among the general population, and among elderly persons in particular, further studies that include controlled prospective trials are needed to confirm our findings.”

The authors suggest that serotonin may be strongly related to bone development. While SSRIs are able to boost serotonin levels in the brain, they may also negatively affect the body’s ability to reabsorb them for use in bone development. They believe that bone-density screening may become important for older patients who are considering the daily use of SSRIs. The research was partially funded by the Canadian Institutes of Health Research along with an assortment of pharmaceutical companies.

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