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SSRI escitalopram did not affect bone metabolism in middle-aged women
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Treatment with escitalopram does not significantly change bone metabolism in the short term, according to research published in The Journal of Clinical Endocrinology & Metabolism.
A study of healthy perimenopausal and postmenopausal women showed escitalopram (Lexapro, Forest Labs) did not have clinically important effects of serum carboxy-terminal collagen crosslinks (CTX) and serum aminoterminal propeptide of type I collagen (P1NP) during 8 weeks.
Susan J. Diem, MD, MPH, of the University of Minnesota, Minneapolis, and colleagues evaluated data from a multisite, placebo-controlled, randomized trial of the selective serotonin reuptake inhibitor (SSRI) to treat menopausal vasomotor symptoms.
The researchers looked at 141 women (mean age, 53.7 years) treated with either escitalopram (10 mg/day to 20 mg/day; n=69) or placebo (n=72); the groups were similar in age, race, BMI, smoking status and mood symptoms.
Using a repeated measures linear regression model, the researchers compared between-group differences in the change in CTX and P1NP, at baseline and end of study; adjustments were made for race, clinical center and baseline measurement.
With escitalopram, serum P1NP decreased by 1.02 ng/mL (95% CI, –5.17 to 3.12) vs. a reduction of 1.88 ng/mL (95% CI, –4.82 to 1.06) with placebo group (P=.65). Similarly, serum CTX decreased by 0.02 ng/mL (95% CI, –0.05 to 0.01) with escitalopram group vs. 0 ng/mL (95% CI, –0.02 to 0.02) with placebo (P=.24). Outcomes remained similar when the analysis was restricted to women whose adherence to study medication was at least 70%.
“These results provide reassurance regarding the absence of bone health effects of these medications when used in generally healthy, non-depressed mid-life women,” the researchers wrote. “It remains uncertain whether this finding can be generalized to other SSRIs or serotonin–norepinephrine reuptake inhibitors or to other populations, such as older postmenopausal women.”
Disclosure: This work was supported by the National Institute of Aging with the Eunice Kennedy Shriver National Institute of Child Health and Development, the National Center for Complementary and Alternative Medicine and the Office of Research on Women’s Health, and the Indiana Clinical and Translational Sciences Institute with a grant from the NIH, National Center for Research Resources and Clinical and Translational Sciences Award.
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