Psychotropic Medications and the Risk of Fracture: A Meta-Analysis
Abstract
Background Older adults throughout the developed world are at significant risk of osteoporotic fractures. Many studies have examined the relationship between the use of psychotropic medications and the risk of fractures, but these studies have reported conflicting results.Purpose To resolve discrepancies, we carried out a meta-analysis to assess the risk of fractures among users of several classes of psychotropic drugs.Data sources We retrieved studies published in any language by systematically searching MEDLINE, LILACS, EMBASE and ISI Proceedings databases and by manually examining the bibliographies of the articles retrieved electronically as well as those of recent reviews.Study selection We included 98 cohort and case-control studies, published in 46 different articles, that reported relative risk (RR) estimates and confidence intervals (CIs) or sufficient data to calculate these values.Data synthesis Study-specific RRs were weighted by the inverse of their variance to obtain fixed- and random effects pooled estimates. The random effects RR of fractures was 1.34 (95% CI 1.24, 1.45) for benzodiazepines (23 studies), 1.60 (95% CI 1.38, 1.86) for antidepressants (16 studies), 1.54 (95% CI 1.24, 1.93) for non-barbiturate antiepileptic drugs (13 studies), 2.17 (95% CI 1.35, 3.50) for barbiturate antiepileptic drugs (five studies), 1.59 (1.27, 1.98) for antipsychotics (12 studies), 1.15 (95% CI 0.94, 1.39) for hypnotics (13 studies) and 1.38 (95% CI 1.15, 1.66) for opioids (six studies). For non-specified psychotropic drugs (10 studies), the pooled RR was 1.48 (95% CI 1.41, 1.59).Limitations Main concerns were the potential for residual confounding and for publication bias.Conclusion Globally, the increase in the risk of fractures among psychotropic drug users is moderate. Further research is needed, especially to examine high-risk populations and newer medications. Future studies should be prospective and emphasise control of confounding bias.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A meta-analysis showed a 33% increased risk of fractures with SSRIs compared to non-SSRI antidepressants; the RR of fractures was 1.60 for antidepressants and 1.59 for antipsychotics.
“A metaanalysis showed a 33% increased risk of fractures with SSRIs compared to non-SSRI AD.The RR of fractures in this metaanalysis was 1.60 for AD and 1.59 for AP (511).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [511]
Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
Risk Factors for Hip Fracture in White Women
Cummings, S. R., Nevitt, M. C., Browner, W. S., Stone, K., Fox, K. M., Ensrud, K. E., Cauley, J., Black, D., & Vogt, T. M. (1995) · New England Journal of Medicine · doi:10.1056/nejm199503233321202 · Cited by 3,595 · see citing works
Cognitive and Behavioral Outcomes of School-Aged Children Who Were Born Preterm: A Meta-analysis
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M., & Anand, K. J. S. (2002) · JAMA · doi:10.1001/jama.288.6.728 · Cited by 2,392 · see citing works
World-wide Projections for Hip Fracture
Gullberg, B., Johnell, O., & Kanis, J. А. (1997) · Osteoporosis International · doi:10.1007/pl00004148 · Cited by 2,300 · see citing works
(2000) · Queen Mary Research Online (Queen Mary University of London) · Cited by 1,795 · see citing works
Preventing Falls in Elderly Persons
Tinetti, M. E. (2003) · New England Journal of Medicine · doi:10.1056/nejmcp020719 · Cited by 1,660 · see citing works
Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs
Leipzig, R. M., Cumming, R. G., & Tinetti, M. E. (1999) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb01898.x · Cited by 1,155 · see citing works
Prevention of falls and consequent injuries in elderly people
Kannus, P., Sievänen, H. T., Palvanen, M., Järvinen, T. L. N., & Parkkari, J. P. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67604-0 · Cited by 1,128 · see citing works
Psychotropic Drug Use and the Risk of Hip Fracture
Ray, W. A., Griffin, M. R., Schaffner, W., Baugh, D. K., & Melton, L. J. (1987) · New England Journal of Medicine · doi:10.1056/nejm198702123160702 · Cited by 1,006 · see citing works
Risk Factors for Falls as a Cause of Hip Fracture in Women
Grisso, J. A., Kelsey, J. L., Strom, B. L., Ghiu, G. Y., Maislin, G., O’Brien, L. A., Hoffman, S., & Kaplan, F. S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199105093241905 · Cited by 869 · see citing works
Central Nervous System–Active Medications and Risk for Falls in Older Women
Ensrud, K. E., BLACKWELL, T. L., Mangione, C. M., Bowman, P. J., Whooley, M. A., Bauer, D. C., Schwartz, A. V., Hanlon, J. T., & Nevitt, M. C. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50453.x · Cited by 621 · see citing works
Campbell, A. J., Robertson, M. C., Gardner, M. M., Norton, R. N., & Büchner, D. M. (1999) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb03843.x · Cited by 552 · see citing works
Benzodiazepines of Long and Short Elimination Half-life and the Risk of Hip Fracture
Ray, W. A. (1989) · JAMA · doi:10.1001/jama.1989.03430230088031 · Cited by 536 · see citing works
Keltner, N. L. (1993) · Cited by 527 · see citing works
Menopausal Estrogen Therapy and Hip Fractures
Paganini‐Hill, A., Ross, R. K., Gerkins, V. R., Henderson, B. E., ARTHUR, M., & Mack, T. M. (1981) · Annals of Internal Medicine · doi:10.7326/0003-4819-95-1-28 · Cited by 468 · see citing works
Liu, B., Anderson, G., Mittmann, N., To, T. M., Axcell, T., & Shear, N. H. (1998) · The Lancet · doi:10.1016/s0140-6736(97)09528-7 · Cited by 387 · see citing works
Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis
Takkouche, B., Cadarso-Suarez, C., & Spiegelman, D. (1999) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009981 · Cited by 380 · see citing works
Self-citationUse of β-Blockers and Risk of Fractures
Schlienger, R. G. (2004) · JAMA · doi:10.1001/jama.292.11.1326 · Cited by 342 · see citing works
Benzodiazepines and Risk of Hip Fractures in Older People
Cumming, R. G., & Couteur, D. G. L. (2003) · CNS Drugs · doi:10.2165/00023210-200317110-00004 · Cited by 332 · see citing works
Herings, R. M. C. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.155.16.1801 · Cited by 331 · see citing works
Costs and health effects of osteoporotic fractures
Chrischilles, E. A., Shireman, T. I., & Wallace, R. B. (1994) · Bone · doi:10.1016/8756-3282(94)90813-3 · Cited by 284 · see citing works
Central Nervous System Active Medications and Risk for Fractures in Older Women
Ensrud, K. E. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.8.949 · Cited by 278 · see citing works
Zolpidem Use and Hip Fractures in Older People
Wang, P. S., Bohn, R. L., Glynn, R. J., Mogun, H., & Avorn, J. (2001) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2001.49280.x · Cited by 272 · see citing works
Ohayon, M. M., & Lader, M. H. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0912 · Cited by 271 · see citing works
Benzodiazepine Use and Hip Fractures in the Elderly
Wagner, A. K., Zhang, F., Soumerai, S. B., Walker, A. M., Gurwitz, J. H., Glynn, R. J., & Ross‐Degnan, D. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.14.1567 · Cited by 243 · see citing works
Fracture Risk Associated with Use of Antiepileptic Drugs
Vestergaard, P., Rejnmark, L., & Mosekilde, L. (2004) · Epilepsia · doi:10.1111/j.0013-9580.2004.18804.x · Cited by 241 · see citing works
Reducing falls and resulting hip fractures among older women
Stevens, J. A., & Olson, S. J. (2000) · Home Care Provider · doi:10.1067/mhc.2000.109232 · Cited by 241 · see citing works
FOOT AND ANKLE FRACTURES IN ELDERLY WHITE WOMEN
Hasselman, C. T., Vogt, M. T., Stone, K. L., Cauley, J. A., & Conti, S. F. (2003) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-200305000-00008 · Cited by 229 · see citing works
Thiazide Diuretics and the Risk for Hip Fracture
Schoofs, M. W. C. J., van der Klift, M., Albert Hofman, D., Laet, C. E. D. H. D., Herings, R. M. C., Stijnen, T., Pols, H. A. P., & Stricker, B. H. C. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-6-200309160-00010 · Cited by 219 · see citing works
An application of propensity score matching using claims data
Seeger, J. D., Williams, P. L., & Walker, A. M. (2005) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1062 · Cited by 218 · see citing works
Fracture risk is increased in epilepsy
Vestergaard, P., Tigaran, S., Rejnmark, L., Tigaran, C., Dam, M., & Mosekilde, L. (1999) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.1999.tb00675.x · Cited by 197 · see citing works
Hubbard, R. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg114 · Cited by 197 · see citing works
Risk Factors for Hip Fracture in Men
Study, H. F., Grisso, J. A., Kelsey, J. L., O’Brien, L. A., Miles, C., Sidney, S. S., Maislin, G., LaPann, K., Moritz, D. J., & Peters, B. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009171 · Cited by 192 · see citing works
Bone mineral density in subjects using central nervous system-active medications
Kinjo, M., Setoguchi, S., Schneeweiss, S., & Solomon, D. H. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.07.033 · Cited by 191 · see citing works
Testosterone Deficiency As a Risk Factor for Hip Fractures in Men: A Case-Control Study
Jackson, J. A., Riggs, M. W., & Spiekerman, A. M. (1992) · The American Journal of the Medical Sciences · doi:10.1097/00000441-199207000-00003 · Cited by 188 · see citing works
Predictors of hip fractures in elderly men
Poór, G., Atkinson, E. J., O’Fallon, W. M., & Melton, L. J. (1995) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650101209 · Cited by 173 · see citing works
Guo, Z., Wills, P., Viitanen, M. H., Fastbom, J., & Winblad, B. G. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009714 · Cited by 167 · see citing works
Effect of positive findings on submission and acceptance rates: A note on meta-analysis bias.
Coursol, A., & Wagner, E. E. (1986) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.17.2.136 · Cited by 165 · see citing works
Opioid Analgesics and the Risk of Hip Fracture in the Elderly: Codeine and Propoxyphene
Shorr, R. I., Griffin, M. R., Daugherty, J. R., & Ray, W. A. (1992) · Journal of Gerontology · doi:10.1093/geronj/47.4.m111 · Cited by 156 · see citing works
Personal Use of Hair Dyes and Risk of Cancer
Takkouche, B., Etminan, M., & Montes, A. (2005) · JAMA · doi:10.1001/jama.293.20.2516 · Cited by 151 · see citing works
Self-citationMagnetic Fields and Breast Cancer in Swedish Adults Residing near High-Voltage Power Lines
Feychting, M., Forssén, U. M., Rutqvist, L. E., & Ahlbom, A. (1998) · Epidemiology · doi:10.1097/00001648-199807000-00008 · Cited by 151 · see citing works
Card, T. R., West, J., Hubbard, R., & Logan, R. F. A. (2004) · Gut · doi:10.1136/gut.2003.026799 · Cited by 146 · see citing works
Benzodiazepines and hip fractures in elderly people: case-control study
Pierfitte, C., Macouillard, G., Thicoïpe, M., Chaslerie, A., Pehourcq, F., Aïssou, M., Martinez, B., Lagnaoui, R., Fourrier, A., Bégaud, B., et al. (2001) · BMJ · doi:10.1136/bmj.322.7288.704 · Cited by 131 · see citing works
Diuretic Drug Use and the Risk for Hip Fracture
Heidrich, F. E. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-1-1 · Cited by 125 · see citing works
Psychotropics, thiazide diuretics and hip fractures in the elderly
Cumming, R. G., & Klineberg, R. J. (1993) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1993.tb121839.x · Cited by 125 · see citing works
Uso de medicamentos como fator de risco para fratura grave decorrente de queda em idosos
Coutinho, E. S. F., & da Silva, S. D. (2002) · Cadernos de Saúde Pública · doi:10.1590/s0102-311x2002000500029 · Cited by 119 · see citing works
Case-Control Study of the Pathogenesis and Sequelae of Symptomatic Vertebral Fractures in Men
Scane, A. C., Francis, R. M., Sutcliffe, A., et al. (1999) · Osteoporosis International · doi:10.1007/s001980050120 · Cited by 116 · see citing works
Cyclic Antidepressants and the Risk of Hip Fracture
Ray, W. A. (1991) · Archives of Internal Medicine · doi:10.1001/archinte.1991.00400040096021 · Cited by 105 · see citing works
Schneeweiß, S., & Wang, P. S. (2004) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000145344.76288.39 · Cited by 87 · see citing works
Outpatient Medications and Hip Fractures in the US
French, D. D., Campbell, R. R., Spehar, A. M., Cunningham, F. E., & Foulis, P. (2005) · Drugs & Aging · doi:10.2165/00002512-200522100-00006 · Cited by 79 · see citing works
Risk of hip/femur fractures in patients using antipsychotics
Hugenholtz, G. W. K., Heerdink, E. R., van Staa, T. P., Nolen, W. A., & Egberts, A. C. G. (2005) · Bone · doi:10.1016/j.bone.2005.07.005 · Cited by 77 · see citing works
Current use of thiazide diuretics and prevention of femur fractures
Herings, R. M. C., Stricker, B. H. C., de Boer, A., Bakker, A., STURMANS, F., & Stergachis, A. S. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(95)00552-8 · Cited by 77 · see citing works
Role of drugs in fractures of the femoral neck.
Rashiq, S., & Logan, R. F. (1986) · BMJ · doi:10.1136/bmj.292.6524.861 · Cited by 76 · see citing works
Paulose‐Ram, R., Jonas, B. S., Orwig, D., & Safran, M. A. (2004) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2003.05.001 · Cited by 76 · see citing works
Risk of Age‐Related Fractures in Patients with Unprovoked Seizures
Annegers, J. F., Melton, L. J., Sun, C., & Hauser, W. A. (1989) · Epilepsia · doi:10.1111/j.1528-1157.1989.tb05308.x · Cited by 74 · see citing works
Mental distress and risk of hip fracture. Do broken hearts lead to broken bones?
Forsén, L., Meyer, H. E., Søgaard, A. J., Næss, S. C. K., Schei, B., & Edna, T. (1999) · Journal of Epidemiology & Community Health · doi:10.1136/jech.53.6.343 · Cited by 70 · see citing works
Risk Factors for Hip Fractures Occurring in the Hospital
Lichtenstein, M. J., Griffin, M. R., Cornell, J. E., Malcolm, E., & Ray, W. A. (1994) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117331 · Cited by 70 · see citing works
HEpiMA: software for the identification of heterogeneity in meta-analysis
Costa, J., Takkouche, B., Cadarso-Suárez, C., & Spiegelman, D. L. (2001) · Computer Methods and Programs in Biomedicine · doi:10.1016/s0169-2607(00)00087-0 · Cited by 69 · see citing works
Self-citationBischof, F., Basu, D., & Pettifor, J. M. (2002) · Developmental Medicine & Child Neurology · doi:10.1017/s0012162201001773 · Cited by 68 · see citing works
Do Drugs Affect the Risk of Hip Fracture in Elderly Women?
Taggart, H. (1988) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1988.tb04367.x · Cited by 58 · see citing works
Reducing falls and resulting hip fractures among older women.
Stevens, J. A., & Olson, S. J. (2000) · PubMed · Cited by 53 · see citing works
Risk Factors for Fractures in the Elderly
Jacqmin-Gadda, H., Fourrier, A., Commenges, D., & Dartigues, J.-F. (1998) · Epidemiology · doi:10.1097/00001648-199807000-00012 · Cited by 52 · see citing works
Oxidative and Nonoxidative Benzodiazepines and the Risk of Femur Fracture
Sgadari, A., Lapane, K. L., Mor, V., Landi, F., Bernabei, R., & Gambassi, G. (2000) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-200004000-00017 · Cited by 47 · see citing works
Psychotropic drug use, falls and hip fracture in the elderly
Schwab, M. G., Röder, F., Aleker, T., Ammon, S., Thon, K.-P., Eichelbaum, M. F., & Klotz, U. E. (2000) · Aging Clinical and Experimental Research · doi:10.1007/bf03339841 · Cited by 38 · see citing works
Sedative-hypnotic drugs and the risk of hip fracture
Wysowski, D. K., Baum, C., Ferguson, W., Lundin, F. E., Ng, M., & Hammerstrom, T. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(95)00057-7 · Cited by 34 · see citing works
Drugs and femoral neck fracture: a case‐control study
Jensen, J. G., Nielsen, L. H., Lyhne, N., Hallas, J., Brøsen, K., & Gram, L. F. (1991) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.1991.tb00302.x · Cited by 33 · see citing works
Partanen, J., Heikkinen, J. E., Jämsä, T. J., & Jalovaara, P. (2002) · Journal of Bone and Mineral Metabolism · doi:10.1007/s007740200053 · Cited by 27 · see citing works
Physician-related barriers to breast cancer screening in older women.
Weinberger, M. M., Saunders, A. F., Bearon, L. B., et al. (1992) · PubMed · Cited by 26 · see citing works
Stevens, A. J., & Mulrow, C. D. (1989) · Journal of Public Health · doi:10.1093/oxfordjournals.pubmed.a042443 · Cited by 23 · see citing works
Drug consumption in patients with hip fractures compared with controls.
Sernbo, I., Hansson, A., & Johnell, O. (1987) · PubMed · Cited by 19 · see citing works
A Cohort Study on the Association between Psychotropics and Hip Fracture in Korean Elderly Women
Bae, J. M., Koo, H. W., Jung, K. O., et al. (2002) · Journal of Korean Medical Science · doi:10.3346/jkms.2002.17.1.65 · Cited by 14 · see citing works
Elderly patients, use of antidepressants, and hip fracture
Gambassi, G., Lapane, K. L., Sgadari, A., et al. (1998) · The Lancet · doi:10.1016/s0140-6736(98)26031-4 · Cited by 7 · see citing works
Macdonald, J. B., & Macdonald, E. T. (1977) · BMJ · doi:10.1136/bmj.2.6091.891-a · Cited by 6 · see citing works
Joint appointments in general and geriatric medicine.
Brocklehurst, J. C., Exton‐Smith, A. N., Hall, M. R., et al. (1977) · BMJ · doi:10.1136/bmj.2.6093.1023-c · Cited by 4 · see citing works
Review: psychotropic drugs increase the risk of falls in older people
Shorr, R. I. (1999) · Evidence-Based Mental Health · doi:10.1136/ebmh.2.3.95 · Cited by 4 · see citing works
Continuing education outside the hospital.
Schaus, R. (1971) · BMJ · doi:10.1136/bmj.2.5763.699-a · Cited by 1 · see citing works
Orsmond, G. I., Seltzer, M. M., Krauss, M. W., & Hong, J. (2003) · American Journal on Mental Retardation · doi:10.1352/0895-8017(2003)108
Flagged first, then by citations
Cited by
Sorted by citations
DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction
Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031914-122957 · Cited by 1,388 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
Lam, R. W., Kennedy, S. H., Grigoriadis, S., McIntyre, R. S., Milev, R., Ramasubbu, R., Parikh, S. V., Patten, S. B., & Ravindran, A. V. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.041 · Cited by 431 · see citing works
Brandt, J., & Leong, C. (2017) · Drugs in R&D · doi:10.1007/s40268-017-0207-7 · Cited by 356 · see citing works
O'Neil, C. K., Hanlon, J. T., & Marcum, Z. A. (2012) · The American Journal of Geriatric Pharmacotherapy · doi:10.1016/j.amjopharm.2012.09.004 · Cited by 261 · see citing works
Depression and frailty in later life: a synthetic review
Mezuk, B., Edwards, L., Lohman, M., Choi, M., & Lapane, K. (2012) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2807 · Cited by 257 · see citing works
Fracture Risk From Psychotropic Medications: A Population-Based Analysis
Bolton, J. M., Metge, C., Lix, L., Prior, H., Sareen, J., & Leslie, W. D. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31817d5943 · Cited by 158 · see citing works
Depression and osteoporosis: epidemiology and potential mediating pathways
Mezuk, B., Eaton, W. W., & Golden, S. H. (2008) · Osteoporosis International · doi:10.1007/s00198-007-0449-2 · Cited by 134 · see citing works
Yoshikawa, A., Ramirez, G., Smith, M. L., Foster, M., Nabil, A. K., Jani, S. N., & Ory, M. G. (2020) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glaa038 · Cited by 122 · see citing works
The Role of Opioid Analgesics in Geriatric Pain Management
Naples, J. G., Gellad, W. F., & Hanlon, J. T. (2016) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2016.06.006 · Cited by 121 · see citing works
Depression, fracture risk, and bone loss: a meta-analysis of cohort studies
Wu, Q., Liu, J., Gallegos-Orozco, J. F., & Hentz, J. G. (2010) · Osteoporosis International · doi:10.1007/s00198-010-1181-x · Cited by 109 · see citing works
Oderda, L. H., Young, J. R., Asche, C. V., & Pepper, G. A. (2012) · Annals of Pharmacotherapy · doi:10.1345/aph.1q589 · Cited by 94 · see citing works
Opioid-induced endocrinopathies
Fountas, A., Van Uum, S., & Karavitaki, N. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30254-2 · Cited by 77 · see citing works
Bone mineral density and its determinants in men with opioid dependence
Gotthardt, F., Huber, C., Thierfelder, C., Grize, L., Kraenzlin, M., Scheidegger, C., & Meier, C. (2017) · Journal of Bone and Mineral Metabolism · doi:10.1007/s00774-015-0732-9 · Cited by 55 · see citing works
Opioids contribute to fracture risk: a meta-analysis of 8 cohort studies
Teng, Z., Zhu, Y., Wu, F., Zhu, Y., Zhang, X., Zhang, C., Wang, S., & Zhang, L. (2015) · PLOS ONE · doi:10.1371/journal.pone.0128232 · Cited by 53 · see citing works
Mezuk, B., Morden, N. E., Ganoczy, D., Post, E. P., & Kilbourne, A. M. (2010) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181bf9ebd · Cited by 36 · see citing works
Opioids increase hip fracture risk: a meta-analysis
Ping, F., Wang, Y., Wang, J., Chen, J., Zhang, W., Zhi, H., & Liu, Y. (2017) · Journal of Bone and Mineral Metabolism · doi:10.1007/s00774-016-0755-x · Cited by 36 · see citing works
Depression as a risk factor for fracture in women: A 10 year longitudinal study
Williams, L. J., Pasco, J. A., Jackson, H., Kiropoulos, L., Stuart, A. L., Jacka, F. N., & Berk, M. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.048 · Cited by 29 · see citing works
Combination psychotropic medicine use in older adults and risk of hip fracture
(2019) · Australian Prescriber · doi:10.18773/austprescr.2019.011 · Cited by 10 · see citing works
- Authors
- Takkouche, B., Montes-Mart??nez, A., Gill, S. S., & Etminan, M.
- Affiliations
- Universidade de Santiago de Compostela (ES)
- Queen's University (CA)
- Vancouver General Hospital (CA)
- Corresponding author
- Takkouche, Bahi
- Venue
- Drug Safety
- Published
- 2007
- Volume
- 30
- Issue
- 2
- Pages
- 171-184
- ISSN
- 0114-5916 (ISSN-L)
- OpenAlex
- W2004582721
- Cited by
- 204
- References
- 80
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 12 · 2020: 6 · 2019: 9 · 2018: 14 · 2017: 15 · 2016: 12 · 2015: 13 · 2014: 8 · 2013: 13 · 2012: 18
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug Safety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- psychotropic drugs, fracture risk, osteoporotic fractures, older adults, benzodiazepines, antidepressants, antiepileptic drugs, barbiturates, antipsychotic drugs, hypnotics, opioids
- MeSH terms
- Adult, Aged, Analgesics, Opioid, Anticonvulsants, Antidepressive Agents, Benzodiazepines, Female, Humans, Hypnotics and Sedatives, Male, Middle Aged, Osteoporosis, Psychotropic Drugs, Risk Factors, Risk Assessment, Fractures, Bone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
