Anti-depressants and Bone Mineral Density

[Jordan Feigenbaum]

Thanks Jordan,

That is great.

Just to clarify, do you mean the risk of fracture with taking TCA's or SSRI's occurs rapidly after the drug is first commenced? And then fracture risk decreases with long term use of the drug?

That's what it looks like, yes!

[aliciaking]

Thanks Jordan,

That is great.

Just to clarify, do you mean the risk of fracture with taking TCA's or SSRI's occurs rapidly after the drug is first commenced? And then fracture risk decreases with long term use of the drug?

[Jordan Feigenbaum]

The most recent meta-analysis on both tricyclic antidepressants (TCAs) and selective serotonin re-uptake inhibitors (SSRIs) show an increased risk of fracture, though this increased risk occurs rapidly and decreases over time suggesting against a decrease in BMD. Some additional data shows a decreased in BND in older men, but not an increased risk of fracture. Of note, this is all observational data.

In any case, weighing the benefits vs risks of treating depression (or other conditions) and risk of osteoporosis and fractures should be weighed under the supposition that the osteoporosis risk is only observational at this time and not well-characterized.

[aliciaking]

Hey guys,


A question based on something I recently read: how does the evidence weigh up regarding antidepressants lowering BMD?

Cheers,

Alicia