Use of selective serotonin reuptake inhibitors and risk of fracture: A systematic review and meta-analysis
Abstract
Previous studies have reported inconsistent findings regarding the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of fracture. We identified relevant studies by searching three electronic databases (MEDLINE, EMBASE, and the Cochrane Library) from their inception to October 20, 2010. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect. We identified 12 studies: seven case-control studies and five cohort studies. A meta-analysis of these 12 observational studies showed that the overall risk of fracture was higher among people using SSRIs (adjusted odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.51-1.90, I(2 ) = 89.9%). Subgroup analysis by adjusted number of key risk factors for osteoporotic fracture showed a greater increased fracture risk in those adjusted for fewer than four variables (adjusted OR = 1.83, 95% CI 1.57-2.13, I(2) = 88.0%) than those adjusted for four or more variables (adjusted OR = 1.38, 95% CI 1.27-1.49, I(2) = 46.1%). The pooled ORs anatomical site of fracture in the hip/femur, spine, and wrist/forearm were 2.06 (95% CI 1.84-2.30, I(2 ) = 62.3%), 1.34 (95% CI 1.13-1.59, I(2 ) = 48.5%), and 1.51 (95% CI 1.26-1.82, I(2 ) = 76.6%), respectively. Subgroup analysis by exposure duration revealed that the strength of the association decreased with a longer window of SSRI administration before the index date. The risk of f…
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SSRI use is associated with an increased risk of fractures.
“SSRI use has also been associated with low bone mineral density [92,93], as well as an increased risk of fractures [94] and hyponatremia [95].”
From Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders (2014) · cites this paper as [94]
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- Authors
- Eom, C.-S., Lee, H.-K., Ye, S., Park, S. M., & Cho, K.-H.
- Affiliations
- Hallym University (KR)
- Seoul National University (KR)
- Corresponding author
- Park, Sang Min
- Cho, Kyung-Hwan
- ORCID
- Park, Sang Min
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-01-18
- Volume
- 27
- Issue
- 5
- Pages
- 1186-1195
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W2062826597
- Cited by
- 123
- References
- 4
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2022: 6 · 2021: 9 · 2020: 10 · 2019: 17 · 2018: 13 · 2017: 8 · 2016: 16 · 2015: 13 · 2014: 11 · 2013: 5 · 2012: 4
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- PubMed (publishedVersion)
- Seoul National University Open Repository (Seoul National University) (submittedVersion)
- Funders
- National Research Foundation of Korea
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- selective serotonin reuptake inhibitors, fracture risk, osteoporotic fractures, hip fracture, spinal fractures, wrist fractures, exposure duration, osteoporosis risk factors, antidepressant side effects, drug safety, fracture site distribution
- MeSH terms
- Depression, Humans, MEDLINE, Selective Serotonin Reuptake Inhibitors, Risk Assessment, Databases as Topic, Fractures, Bone
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