DSEN Abstract
Selective serotonin reuptake inhibitors (SSRI) and risks of fracture

This research was funded by the Drug Safety and Effectiveness Network (DSEN) and conducted by the following investigators: C. Moura, S. Bernatsky, M. Abrahamowicz et al. The statements made herein are those of the stated authors, who are independent researchers.

What is the issue?

  • Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) may increase the risk of fractures.
  • The rationale is that these drugs can increase the risk of falls and decrease bone mineral density.

Summary and Key messages

In our analysis using data from a population-based cohort, SSRI/SNRI use was associated with increased risk of fragility fracture. After controlling for multiple risk factors, the adjusted hazard ratio for current SSRI/SNRI use was elevated (HR, 1.68; 95 % CI, 1.32– 2.14).

Our results suggest an independent association between SSRI/SNRI use and subsequent fragility fracture. Given the high prevalence of antidepressants use, and the impact of fractures on the health, our findings may have a significant clinical impact.

For more information, please contact Cristiano Moura cristiano.soaresdemoura@mail.mcgill.ca

What was the aim of the study?

  • To evaluate whether antidepressant medication use is associated with fracture risk.

How was the study conducted?

  • We used 10-year data from the Canadian Multicentre Osteoporosis Study (CaMos).
  • Occurrence of fractures was assessed annually and drug exposure at 3 time points during the study period.
  • Time to event analysis was used to assess the association between SSRI/SNRI use and time to first fragility fracture.

What did the study find?

  • Among 6,645 selected participants, 978 experienced at least one fragility fracture.
  • Current use of either SSRI/SNRI was associated with an increased risk of fragility fracture (HR, 1.68; 95 % CI, 1.32–2.14).
  • The results also suggest a dose-effect relationship: participants taking higher doses of SSRI/SNRI at baseline had a significantly higher risk of fracture.

Link to publication: Moura et al, 2014.

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