SSRIs May Increase Fracture Risk
An additional study found that drugs used to treat depression and other mental illnesses may heighten the risk of fractures. Dr. Brent Richards from McGill University, working with researchers in the Canadian Multicentre Osteoporosis Study (CaMos) presented the findings. According to the study's results, daily use of selective serotonin reuptake inhibitors (SSRIs)-which rank among the most widely prescribed drugs in the world with combined annual sales of US $8.3 billion- were associated with an elevated risk of X-ray confirmed fragility fractures among subjects aged 50 years and above. “The take home message is that SSRI use, depression and fractures are common in the elderly,” Richards said. “So, given these high prevelances, the effect of SSRI use on fractures may have important public health implications.”
Prior studies by other researchers dating back to 1998 also linked fractures and SSRI use. However, these earlier studies failed to adequately address the role of potential confounders, Richards said. Although care must be taken in the interpretation of any observational study, to help to isolate SSRI effects, the current study controlled for age, sex, bone mineral density (BMD), falls, cigarette smoking, nutrition, and many other factors that can also exacerbate fracture risk. SSRIs in particular are known to be associated with low BMD and increased risk of falling. But even after accounting for falls and low BMD, SSRIs produced a two-fold elevation in fracture risk, leading the CaMos researchers to suspect that other, unknown mechanisms are at play. “It's important to note the study was done in older subjects,” Richards said. “For younger individuals, the risk of fractures associated with SSRIs is likely to be smaller. But if you're over 50 years of age and at an increased risk of fracture, then SSRIs may increase this risk further. On the other hand, one must also consider that the treatment of depression may confer substantial benefit to patients with this condition.”
An additional study found that drugs used to treat depression and other mental illnesses may heighten the risk of fractures. Dr. Brent Richards from McGill University, working with researchers in the Canadian Multicentre Osteoporosis Study (CaMos) presented the findings. According to the study's results, daily use of selective serotonin reuptake inhibitors (SSRIs)-which rank among the most widely prescribed drugs in the world with combined annual sales of US $8.3 billion- were associated with an elevated risk of X-ray confirmed fragility fractures among subjects aged 50 years and above. “The take home message is that SSRI use, depression and fractures are common in the elderly,” Richards said. “So, given these high prevelances, the effect of SSRI use on fractures may have important public health implications.”
Prior studies by other researchers dating back to 1998 also linked fractures and SSRI use. However, these earlier studies failed to adequately address the role of potential confounders, Richards said. Although care must be taken in the interpretation of any observational study, to help to isolate SSRI effects, the current study controlled for age, sex, bone mineral density (BMD), falls, cigarette smoking, nutrition, and many other factors that can also exacerbate fracture risk. SSRIs in particular are known to be associated with low BMD and increased risk of falling. But even after accounting for falls and low BMD, SSRIs produced a two-fold elevation in fracture risk, leading the CaMos researchers to suspect that other, unknown mechanisms are at play. “It's important to note the study was done in older subjects,” Richards said. “For younger individuals, the risk of fractures associated with SSRIs is likely to be smaller. But if you're over 50 years of age and at an increased risk of fracture, then SSRIs may increase this risk further. On the other hand, one must also consider that the treatment of depression may confer substantial benefit to patients with this condition.”
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