Use of Antidepressants and Rates of Hip Bone Loss in Older Women: The Study of Osteoporotic Fractures
Abstract
BACKGROUND: Serotonin transporters have recently been described in bone, raising the possibility that medications that block serotonin reuptake could affect bone metabolism. METHODS: We assessed current use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) and obtained serial bone mineral density (BMD) measurements in a cohort of 2722 older women (mean age, 78.5 years) participating in the Study of Osteoporotic Fractures, a prospective cohort study of community-dwelling women. Hip BMD was measured at the sixth examination and an average of 4.9 years later at the eighth examination. We categorized women as nonusers (used no SSRIs or TCAs at either examination; n=2406), SSRI users (used SSRIs but no TCAs at either examination; n=198), or TCA users (used TCAs but no SSRIs at either examination; n=118). Depressive symptoms were identified using a cutoff score of at least 6 on the Geriatric Depression Scale. RESULTS: After adjustment for potential confounders, including the Geriatric Depression Scale score, mean total hip BMD decreased 0.47% per year in nonusers compared with 0.82% in SSRI users (P<.001) and 0.47% in TCA users (P=.99). Higher rates of bone loss were also observed at the 2 hip subregions for SSRI users. Results were not substantially altered when women who scored at least 6 on the Geriatric Depression Scale were excluded from the analysis. CONCLUSION: Use of SSRIs but not TCAs is associated with an increased rate of bone loss at the hip in this cohort of older women.
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This finding seems to be restricted to the SSRI class of antidepressants.
“However, this finding seems to be restricted to the SSRI class of AD (500-502).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [501]
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- Authors
- Diem, S. J.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Diem, Susan J.
- ORCID
- Diem, Susan J.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2007-06-25
- Volume
- 167
- Issue
- 12
- Pages
- 1240
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2090973045
- Cited by
- 326
- References
- 32
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 7 · 2023: 10 · 2022: 11 · 2021: 8 · 2020: 12 · 2019: 6 · 2018: 19 · 2017: 15 · 2016: 19 · 2015: 18 · 2014: 22 · 2013: 22 · 2012: 25
- FWCI
- 33.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01AG008415, AG05394, AG 08415, AG-05407)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR035584, K23AR051926, AR35583, AR-35584, AR 35582, R01AR035582, R01AR035583)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- antidepressants, selective serotonin reuptake inhibitors, tricyclic antidepressants, bone loss, hip bone density, osteoporosis, older women, serotonin transporter, bone metabolism, depressive symptoms, Study of Osteoporotic Fractures
- MeSH terms
- Aged, Antidepressive Agents, Tricyclic, Bone Resorption, Depression, Female, Follow-Up Studies, Hip Fractures, Humans, Osteoporosis, Prognosis, Prospective Studies, Surveys and Questionnaires, Risk Factors, Time Factors, United States, Absorptiometry, Photon, Bone Density, Incidence, Selective Serotonin Reuptake Inhibitors
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