Today’s issue is about the new research on Osteopenia, Depression and anti-depression medications.
If you have experienced depression or think it could be a force in your life as you age, this newsletter is worth reading. If you have no interest in depression, read no further!
Depression Osteopenia and Osteoporosis.
It has long been known the depression is connected with bone loss and fracture. But there is growing evidence that some of the popular antidepressant drugs, the class known as Selective Serotonin Reuptake Inhibitors SSRI (eg. prozac, zoloft, paxil, lexapro, luvox and celexa. ) are also associated with bone loss and fracture.
BACKGROUND: There was a study in 2005 that seemed to indicate that these drugs interfered with the Osteoclast/Osteoblast cycle of bone remodeling.
In January 2007 Canadian researches published a study which found that daily use of Selective Serotonin Reuptake Inhibitors by adults 50 years and older was associated with a 2-fold increased risk of clinical fragility fractures. Also the taking of the SSRI is associated with a greater number of falls.
The study involveded 137 patients whose average age was 65 and who took SSRIs. Bone mineral density was measured at the start of the study and each year for the next 5 years. Patients were also asked about fractures they had and how they occurred. Daily SSRI use was associated with a 4 percent decrease in bone mineral density at the hip, and a 2.4 percent decrease at the spine, the researchers reported.
The researchers found that the patients had twice the risk of fractures. Most had fractures of the forearm, ankle and foot. Fewer broke their hips, ribs, femur, or spine.. And patients had an increased risk of falling. The effect depended on the dose of the drug eg. there was a 1.5 increase in risk of falling with a doubling of a patient’s dose.
It'S been known for a long time that there is a connection between depression and Osteoporosis as well as between depression and increased falls At least one critic of the Canadian study called for a new study comparing persons with depression who are not on SSRI medication with those who are on SSRI medication to see if there is a difference.
Because depression is serious, there is some concern in the health care community that patients might stop taking their SSRI medication after reading about these studies in th epopular press. Patients need to discuss the issue with their doctors.
SUGGESTION: If you have problems with depression, talk with your health care provider about it - especially in relation to your Osteopenia or Osteoporosis.
If you are on one of the SSRI medications for depression, talk with your health care provider about the research concerning these drugs and Osteopenia AND Osteoporosis. There may be other medication options OR your bone health many need special monitoring.
In any case it would be smart for anyone who lives with depression, whether they are on medication or not, to spend a few minutes each day on BALANCE AND CO-ORDINATION exercises. (Check the web site for these) It is a simple thing you can do for yourself during a difficult time. And you may well prevent a fall and/or fracture.
Lernet, UH. "Serotonin reuptake inhibitors may increase the risk of osteoporosis" Lakartidningen. 2005 Sep 26-Oct 2;102(39):2746-9.
P. Vestergaard, L. Rejnmark and L. Mosekilde " Anxiolytics, sedatives, antidepressants, Neuroleptics and the Risk of Fracture" Osteoporosis International Volume 17, Number 6 / June, 2006
J. Brent Richards, MD; Alexandra Papaioannou, MD, MSc; Jonathan D. Adachi, MD; Lawrence Joseph, PhD; Heather E. Whitson, MD; Jerilynn C. Prior, MD; David Goltzman, MD; for the Canadian Multicentre Osteoporosis Study (CaMos) "Research Group Effect of Selective Serotonin Reuptake Inhibitors on the Risk of Fracture." Arch Intern Med. 2007;167:188-194.