Antidepressant Use May Boost Fracture Risk, From Harvard Women's Health Watch

Evidence is accumulating that
depression is a risk factor for osteoporosis, reports the June 2007 issue
of Harvard Women's Health Watch. A recent study found that people ages 50
and over who regularly took antidepressants called selective serotonin
reuptake inhibitors (SSRIs) had double the rate of fractures as people not
using such medications. Other research points to depression itself as a
source of endocrine changes that can damage bone.



Whether the danger comes from depression, the drugs used to treat it,
or something else, doctors are paying more attention to this association.
During the 1990s, depression began to emerge as a possible cause of bone
loss, rather than a result. Scientists studied women who didn't have
osteoporosis symptoms or even know they had the condition. They found lower
bone mineral density in those who were depressed. Moreover, the link was
found in both younger women and women past menopause. Other studies have
found a similar relationship, so investigators have been looking at
hormones and brain chemicals potentially involved in both depression and
bone loss.



Researchers working with an animal model found that depression triggers
the release of noradrenaline, which interferes with bone-building cells.
Moreover, they found that imipramine-a member of an older class of drugs
called tricyclic antidepressants-reversed both depression and depression-
induced bone loss.



It may be a long time before the depression-osteoporosis connection is
fully clarified. In the meantime, Harvard Women's Health Watch suggests
that you continue taking an antidepressant if you already use one;
depression is a serious illness that can have profound consequences. You
may also want to talk to your doctor about getting a bone density test, and
make sure you get adequate calcium.


Harvard Health Publications

health.harvard.edu/women