Depression Medications Might Thin Bones
Effect has been found among older people taking SSRIs

(HealthDay News) -- The commonly prescribed anti-depressant medications known as SSRIs might increase the rate of bone loss, two studies have suggested.

At least one expert was quick to point out, however, that people shouldn't abandon their depression treatment medications.

Dr. Susan Diem, an assistant professor of medicine at the University of Minnesota and lead author of one of the studies, said that the findings were preliminary and that "further research is needed before any firm conclusions can be drawn."

SSRIs -- selective serotonin reuptake inhibitors -- are used to treat clinical depression. Symptoms of clinical depression include a persistent sad or empty mood, sleeping too much or too little, loss of enjoyment from once-pleasurable activities, difficulty concentrating, feelings of hopelessness and thoughts of suicide or death, according to Mental Health America .

As many as two-thirds of antidepressant prescriptions are for SSRIs, which work by disrupting the protein that transports the neurotransmitter serotonin. Serotonin is involved in depression and sleep. SSRIs are also sometimes used to treat pain disorders. Common brand names include Paxil, Prozac and Zoloft.

Recently, receptors for serotonin have been discovered in bone, which led researchers to wonder if medications that interfere with serotonin delivery, such as SSRIs, would cause problems with bone.

The first study included nearly 3,000 women, who averaged 78 years old. Bone density was measured at the start of the study and then again five years later.

Women who took SSRIs had a decrease of 0.82 percent in the bone mineral density in their hip, compared with a 0.47 percent drop among women who took older anti-depressants called tricyclics and among women who took no antidepressants.

"We found that the use of the SSRIs was associated with increased rates of bone loss in this group of older women, but this research cannot definitively determine whether the drugs themselves are responsible for the increased rates of bone loss or whether other differences between SSRI users and those who don't use SSRIs are responsible," Diem said. The findings need to be confirmed in other populations, she said.

"The real question," Diem said, "is whether the drugs have an effect on the rate of fracture, and that we could not address."

The second study, done by Canadian researchers, included almost 6,000 men older than 65. In men, the differences were more pronounced. Bone mineral density was 3.9 percent lower in the hip in men taking SSRIs than it was in men who were not taking antidepressants.

The study also looked at spine bone mineral density, finding a 5.9 percent decrease in bone mineral density for men on SSRIs.

Both studies were published in the Archives of Internal Medicine .

On the Web

To learn more about depression treatment and possible side effects, visit the National Institute of Mental Health.

SOURCES: HealthDay News ; Susan J. Diem, M.D., assistant professor of medicine, University of Minnesota School of Medicine, Minneapolis; June 25, 2007, Archives of Internal Medicine ; Mental Health America (www.nmha.org)
Author: Serena Gordon
Publication Date: July 31, 2008
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