Health A to Z

Seniors' Health: Antidepressants increase risk of bone fractures

Seniors taking selective serotonin reuptake inhibitors should take steps to help prevent osteoporosis

Elderly people taking certain types of daily medication for depression have a twofold increased risk of bone fractures, according to a Canadian study.

The research involved more than 5,000 adults age 50 years and older, 137 of whom took antidepressants called selective serotonin reuptake inhibitors (SSRIs) on a daily basis. These medications include Prozac, Paxil, Zoloft and other brands.

Dr. David Goltzman, a study co-author and professor of medicine at McGill University in Montreal, says previous studies had linked SSRIs with increased fracture risk in the elderly, but they hadn’t been able to account for other risk factors such as bone density or physical activity level.

In the latest study, people taking SSRIs daily had an increased risk of falls and a lower bone density at the hip. Over a five-year period, they had double the fracture risk of their counterparts not taking the drugs. The broken bones occurred in the forearm, ankle, foot, hip, rib, thigh and back.

Goltzman says studies in mice have suggested that serotonin – a chemical messenger in the brain – affects the ability of bone-forming cells to make bone in the right amount and structure. But he does not recommend that seniors stop using SSRIs or not start the medications if they need them.

If SSRIs are required, he says people should institute lifestyle changes that are usually recommended for preventing osteoporosis, “which means physical activity, having an adequate amount of calcium and vitamin D in your diet, a moderate amount of alcohol (intake) and not smoking.”

It’s also prudent for seniors to have a bone mineral density test done, especially if they haven’t started an SSRI yet, or to have this test done at intervals if they are already using SSRIs. If doctor-recommended, they should also go on anti-osteoporosis medication.