February 11, 2009 5:27 PM
- Text
Study: Antidepressants Boost Fracture Risk
(AP)
Older adults who take daily doses of such popular antidepressants as Prozac and Paxil are more prone to falls and have double the risk of fractures, says a Canadian study, adding one more side-effect that patients must consider before taking the medication.
Participants in the McGill University study who had been taking one of the selective serotonin reuptake inhibitors, or SSRIs, for at least five years had twice the risk of wrist, ankle, hip and other fractures compared with those not prescribed the drugs.
Daily use of SSRIs was also associated with a 4 percent reduction in bone mineral density of the hip and 2.4 percent of the lower spine, researchers found. The risk of falling was also higher among those taking the pills, which can cause a drop in blood pressure and fainting in some people.
"Depression is common in the elderly, and the elderly population is increasing in Canada and most of the western world," said Dr. David Goltzman, a Montreal endocrinologist and senior author of the study, published Tuesday in the Archives of Internal Medicine.
"So depression is increasing as the population ages and the use of SSRIs is increasing at a phenomenal rate," Goltzman said, noting that prescriptions for the medications soared by more than 30 percent between 2000 and 2004.
"And that puts a lot of people at increased risk for fractures over and above the risk that they already have as a result of the fact that they're aging and are taking other medication which may also predispose to osteoporosis."
But Goltzman stressed the findings do not mean that people should stop taking the antidepressants.
"I think that if they need an SSRI, if their physician feels that they need it to treat their depression . . . they need to be treated with the appropriate medication," he said. "It just means individuals should be aware this is a side-effect and they should probably also take general steps in order to prevent osteoporosis."
Those steps include engaging in weight-bearing exercise, eating a diet rich in calcium and vitamin D, and avoiding smoking and alcohol.
Goltzman also suggests that older patients should have their bone density tested when they begin taking an SSRI and again after they have been on the drug for a period of time to see if their bones are thinning.
The study tracked 5,008 Canadians aged 50 and older for five years, including 137 who reported using SSRI antidepressants daily. In this smaller group, 18 people or 13.5 percent had fractures during the study period, compared with 317 people with fractures, or 6.5 percent, among 4,871 who didn't take the pills.
The research is part of the much larger, 10-year Canadian Multicentre Osteoporosis Study (CAMOS) funded by the Canadian Institutes of Health Research, drug companies that include Eli Lilly Canada and Merck Frosst Canada, the Dairy Farmers of Canada and the Arthritis Society.
Participants in the McGill University study who had been taking one of the selective serotonin reuptake inhibitors, or SSRIs, for at least five years had twice the risk of wrist, ankle, hip and other fractures compared with those not prescribed the drugs.
Daily use of SSRIs was also associated with a 4 percent reduction in bone mineral density of the hip and 2.4 percent of the lower spine, researchers found. The risk of falling was also higher among those taking the pills, which can cause a drop in blood pressure and fainting in some people.
"Depression is common in the elderly, and the elderly population is increasing in Canada and most of the western world," said Dr. David Goltzman, a Montreal endocrinologist and senior author of the study, published Tuesday in the Archives of Internal Medicine.
"So depression is increasing as the population ages and the use of SSRIs is increasing at a phenomenal rate," Goltzman said, noting that prescriptions for the medications soared by more than 30 percent between 2000 and 2004.
"And that puts a lot of people at increased risk for fractures over and above the risk that they already have as a result of the fact that they're aging and are taking other medication which may also predispose to osteoporosis."
But Goltzman stressed the findings do not mean that people should stop taking the antidepressants.
"I think that if they need an SSRI, if their physician feels that they need it to treat their depression . . . they need to be treated with the appropriate medication," he said. "It just means individuals should be aware this is a side-effect and they should probably also take general steps in order to prevent osteoporosis."
Those steps include engaging in weight-bearing exercise, eating a diet rich in calcium and vitamin D, and avoiding smoking and alcohol.
Goltzman also suggests that older patients should have their bone density tested when they begin taking an SSRI and again after they have been on the drug for a period of time to see if their bones are thinning.
The study tracked 5,008 Canadians aged 50 and older for five years, including 137 who reported using SSRI antidepressants daily. In this smaller group, 18 people or 13.5 percent had fractures during the study period, compared with 317 people with fractures, or 6.5 percent, among 4,871 who didn't take the pills.
The research is part of the much larger, 10-year Canadian Multicentre Osteoporosis Study (CAMOS) funded by the Canadian Institutes of Health Research, drug companies that include Eli Lilly Canada and Merck Frosst Canada, the Dairy Farmers of Canada and the Arthritis Society.
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