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Antidepressents may Lower Bone Density in Older People

ory is supported by findings of in vitro and in vivo laboratory investigations. Some data suggest that SSRIs may interfere with the function of osteoclasts and osteoblasts, cells responsible for the regular breaking down and rebuilding of bone in the body.

Our findings suggest that, in this cohort, use of SSRIs is associated with increased rates of hip bone loss, the authors conclude. Although some of this association may have occurred because women who were prescribed SSRIs were different from those who were not prescribed SSRIs, further investigation of SSRI use and rates of change in bone mineral density in other populations with longer follow-up is warranted given the recent description of serotonin transporters in bone.

In a related paper, Elizabeth M. Haney, M.D., of Oregon Health & Sciences University, Portland, and colleagues conducted a similar study with 5,995 men age 65 and older (average age 73.7). The mens bone density at the hip, including subregions, and at the base of the spine were measured between 2000 and 2002. Participants were asked to bring all medications to their clinic visit, where they were also given a physical examination and asked about other health and lifestyle factors.

A total of 160 (2.7 percent) men reported using SSRIs, 99 (1.7 percent) reported using tricyclic antidepressants and 52 (0.9 percent) reported using trazodone, a third type of antidepressant. Total hip bone mineral density was 3.9 percent lower among SSRI users than among men who didnt use any antidepressants.

Similarly, spine bone mineral density was 5.9 percent lower among SSRI users than among non-users. There was no significant difference in either hip or spine density between men who took tricyclic antidepressants or trazodone and those who did not take antidepressants.

These associations are biologically plausible and clinically important, the authors conclude. Because SSRI use is prevalent in t
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