Antidepressants in elderly associated with increased fractures

Daily use of the antidepressant medications, known as selective serotonin reuptake inhibitors (SSRIs) by adults 50 years and older had a two-fold increased risk of incident clinical fragility fracture even after adjustment for many potential confounding variables, said the researchers.

J Brent Richards of McGill University and colleagues evaluated 5,008 community-dwelling adults 50 years and older who were followed up for over five years for incident fractures. Researchers examined the relationships between SSRI use, bone mineral density (BMD) and falls.

During the initial interview, the daily use of SSRIs was associated with an increased risk of falling. The effect was dose-dependent; doubling the daily dose of SSRIs increased the odds of falling 1.5-fold during the previous month. Daily use of SSRIs was also associated with a 4% decreased BMD at the total hip and a 2.4% decrease at the lumbar spine.

Past studies have found the use of these antidepressants to be associated with an increased risk of clinical fragility fracture (fractures due to falling from bed, chair or standing height), but did not reliably examine such factors as falls and bone mineral density, the authors noted.

The authors said: “In light of the high rate of SSRI use among the general population, and among elderly persons in particular, further studies that include controlled prospective trials are needed to confirm our findings.”