Issue: October 2013
September 06, 2013
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Antidepressants did not increase risk for bone loss in middle-aged women

Issue: October 2013
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Although previous studies have suggested selective serotonin reuptake inhibitors and tricyclic antidepressants have adverse effects on bone mineral density, a recent prospective study at five clinical centers in the United States demonstrates there is no increased risk for bone loss at the spine, total hip or femoral neck.

According to Susan J. Diem, MD, MPH, from the department of medicine and division of epidemiology and community health at the University of Minnesota in Minneapolis, and colleagues, these findings did not vary by level of depressive symptoms.

“Our findings should provide reassurance for women in midlife regarding the effects of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) on bone loss during the menopausal transition,” researchers wrote.

The study compared the annual BMD changes among community-dwelling women (aged 42 years and older) categorized as: nonusers (n=1,590), those taking SSRIs (n=311) or TCAs (n=71). All of the patients were enrolled in the Study of Women’s Health Across the Nation (SWAN), researchers wrote.

According to data, mean lumbar spine BMD decreased 0.68% per year in nonusers, 0.63% in SSRI users and 0.40% per year in TCA users, signaling no statistically significant increased rate of bone loss. Similarly, patients on SSRIs or TCAs displayed no significant bone loss at the total hip and femoral neck, researchers wrote.

In a secondary stratified analysis of depressive symptoms, Diem and colleagues reported no increase in the rate of bone loss among SSRI users or TCA users.

Disclosure: Solomon reports support from NIH grant K24 AR055989 and grant support from Eli Lilly and Amgen for unrelated projects and serves in unpaid roles on two Pfizer-sponsored trials of analgesics. All other researchers report no relevant financial disclosures.