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Effect of selective serotonin reuptake inhibitors on the risk of fracture.
Arch Intern Med. 2007 Jan 22; 167(2):188-94.AI

Abstract

BACKGROUND

Depression and osteoporotic fractures are common ailments among elderly persons. Selective serotonin reuptake inhibitors (SSRIs) are frequently used in the treatment of depression in this population, and the association between daily SSRI use and fragility fractures is unclear. Our objective was to examine the effect of daily SSRI use on the risk of incident clinical fragility fracture.

METHODS

A population-based, randomly selected, prospective cohort study of 5008 community-dwelling adults 50 years and older, followed up over 5 years for incident fractures. Clinical fragility fractures were classified as minimal trauma fractures that were clinically reported and radiographically confirmed. The risk of fragility fracture associated with daily SSRI use was determined while controlling for relevant covariates.

RESULTS

Daily SSRI use was reported by 137 subjects. After adjustment for many potential covariates, daily SSRI use was associated with substantially increased risk of incident clinical fragility fracture (hazard rate, 2.1; 95% confidence interval, 1.3-3.4). Daily SSRI use was also associated with increased odds of falling (odds ratio, 2.2; 95% confidence interval, 1.4-3.5), lower bone mineral density at the hip, and a trend toward lower bone mineral density at the spine. These effects were dose dependent and were similar for those who reported taking SSRIs at baseline and at 5 years' follow-up.

CONCLUSIONS

Daily SSRI use in adults 50 years and older remained associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential covariates. Depression and fragility fractures are common in this age group, and the elevated risk attributed to daily SSRI use may have important public health consequences.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17242321

Citation

Richards, J Brent, et al. "Effect of Selective Serotonin Reuptake Inhibitors On the Risk of Fracture." Archives of Internal Medicine, vol. 167, no. 2, 2007, pp. 188-94.
Richards JB, Papaioannou A, Adachi JD, et al. Effect of selective serotonin reuptake inhibitors on the risk of fracture. Arch Intern Med. 2007;167(2):188-94.
Richards, J. B., Papaioannou, A., Adachi, J. D., Joseph, L., Whitson, H. E., Prior, J. C., & Goltzman, D. (2007). Effect of selective serotonin reuptake inhibitors on the risk of fracture. Archives of Internal Medicine, 167(2), 188-94.
Richards JB, et al. Effect of Selective Serotonin Reuptake Inhibitors On the Risk of Fracture. Arch Intern Med. 2007 Jan 22;167(2):188-94. PubMed PMID: 17242321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of selective serotonin reuptake inhibitors on the risk of fracture. AU - Richards,J Brent, AU - Papaioannou,Alexandra, AU - Adachi,Jonathan D, AU - Joseph,Lawrence, AU - Whitson,Heather E, AU - Prior,Jerilynn C, AU - Goltzman,David, AU - ,, PY - 2007/1/24/pubmed PY - 2007/2/17/medline PY - 2007/1/24/entrez SP - 188 EP - 94 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 167 IS - 2 N2 - BACKGROUND: Depression and osteoporotic fractures are common ailments among elderly persons. Selective serotonin reuptake inhibitors (SSRIs) are frequently used in the treatment of depression in this population, and the association between daily SSRI use and fragility fractures is unclear. Our objective was to examine the effect of daily SSRI use on the risk of incident clinical fragility fracture. METHODS: A population-based, randomly selected, prospective cohort study of 5008 community-dwelling adults 50 years and older, followed up over 5 years for incident fractures. Clinical fragility fractures were classified as minimal trauma fractures that were clinically reported and radiographically confirmed. The risk of fragility fracture associated with daily SSRI use was determined while controlling for relevant covariates. RESULTS: Daily SSRI use was reported by 137 subjects. After adjustment for many potential covariates, daily SSRI use was associated with substantially increased risk of incident clinical fragility fracture (hazard rate, 2.1; 95% confidence interval, 1.3-3.4). Daily SSRI use was also associated with increased odds of falling (odds ratio, 2.2; 95% confidence interval, 1.4-3.5), lower bone mineral density at the hip, and a trend toward lower bone mineral density at the spine. These effects were dose dependent and were similar for those who reported taking SSRIs at baseline and at 5 years' follow-up. CONCLUSIONS: Daily SSRI use in adults 50 years and older remained associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential covariates. Depression and fragility fractures are common in this age group, and the elevated risk attributed to daily SSRI use may have important public health consequences. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/17242321/Effect_of_selective_serotonin_reuptake_inhibitors_on_the_risk_of_fracture_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.167.2.188 DB - PRIME DP - Unbound Medicine ER -