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Antidepressants Linked to Increased Bone Fracture Risk

Patients over age 50 who take commonly prescribed antidepressants daily are at twice the risk of bone fracture from falling, according to a January 22nd study in the Archives of Internal Medicine. The study concluded with a 95% confidence interval that risk of fracture from low-trauma events such as falling from a standing height increased by 210% when the patient was using antidepressants known as selective seratonin reuptake inhibitors (SSRIs), which include Prozac, Paxil, Celexa and Zoloft on a daily basis.

About 10% of older Americans suffer from depression, and SSRIs are commonly prescribed as treatment because of their presumed "relatively benign side effect profile". Previous studies had noticed a link between falls, fractures and SSRI use, but did not have the ability to control for additional complicating factors.

In this study, 5000 patients over the age of 50 (average age 65) were followed for 5 years. All patients had bone mineral density of their hip and low back measured at the beginning of the study. Patients also agreed to filling out yearly questionnaires regarding falls and fractures, especially "minimal trauma" fractures that occur when falling from a bed, chair, or standing height. All fractures were confirmed via radiography, and occurred everywhere from the forearm to rib, hip, femur and back. Of the 5000 participants, 137 were taking SSRIs continuously throughout the course of the study.

Dr. David Goltzman, the study's senior author and director of McGill University's Metabolic Bone Disease Centre summarized:
"Basically what this shows is that the SSRIs produce a doubling in the risk of developing fractures than if you were not taking them. It's still an association study, but it certainly suggests very strongly that SSRIs can pre-dispose to fractures, probably by reducing the amount of bone and possibly by altering the quality of bone as well."
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