Common Antidepressants in Menopause Cause Bones to Break

Antidepressents Linked to Bone Fractures
Mache Seibel, MD

Taking Antidepressants in Menopause Weakens Bones, Increases Fractures

Antidepressants like Celexa, Effexor, Paxil and Prozac could put you at risk for bone fractures.

It's no secret that menopause can cause a very big change in mood and focus. Many women complain they are feeling anxious or a bit sad. Some get down right depressed and ask their healthcare provider for relief. Currently some 23% of women in their 40s and 50s take antidepressants, higher than any other group by age and sex and less than one third of Americans who take a single antidepressant (as opposed to two or more) have seen a mental health professional in the past year.

Women are 2.5 times more likely than men to take and antidepressant. Perhaps they are more open to getting help, or maybe they symptoms of menopause create additional stresses that impact the quality of their lives. Many of these women are prescribed a common class of antidepressants called SSRIs or Selective Serotonin Reuptake Inhibitors. In addition, additional numbers of women are prescribed an SSRI to ease menopausal symptoms such as hot flashes as an alternative to hormone therapy (HT). Now new research suggests these women could be increasing their risk for bone fracture.

According to Dr. Matthew Miller of Northeastern University in Boston, "SSRIs appear to increase fracture risk among middle aged women without psychiatric disorders." The author's team added that the effect seems to be "sustained over time, suggesting that shorter duration of treatment may decrease [this effect]."

Although the SSRIs may not directly cause the bone fractures, they are associated with bone an increase of bone fractures.

However, the authors say that their research is not the first study to link SSRIs with they point out that prior research has highlighted bone-thinning.

Findings from the study were published June 25 in the journal Injury Prevention.

To research their findings, the researchers reviewed data from the PharMetrics Claims Database, an information colleting system that has information on drug treatments of roughly 61 million patients nationally.

The researchers reviewed records from over 137,000 women between 40 and 64 years who began taking SSRIs between 1998 and 2010. The SSRIs they took included citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Sarafem, Prozac), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft). These women were then compared with more than 236,000 other women who had been prescribed indigestion medications instead of an SSRI.

            The SSRI group had a 76 percent higher risk for fracture after just one year of SSRI use, compared with the non-SSRI group. After two years, the percentage dropped to 73 percent and after 5 years it dropped further to 67 percent after five years.

Why does this happen? The authors believe it could be that the SSRIs increase the activity of osteoclasts, cells that break down bone. If you are taking an SSRI for a year or more, talk with your doctor about getting a bone density to see if you are losing bone. That way you can take steps to prevent a bone fracture.

You can also consider taking vitamin D3 and calcium if you are on antidepressant SSRIs to help maintain strong bones and continue to exercise, which can help your bones and help to treat depression. The important thing is to realize that helping one important symptom could be having a negative impact on other aspects of your health. But if you are aware of the possible problem, steps can be taken to prevent it from happening.

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