From
NEWSInferno.com: Antidepressants Can Increase Fracture Risk
More and more studies are indicating that antidepressants such as
Paxil and
Prozac are putting older people at increased risk for fractures. As a matter-of-fact, in one of the more recent reports, Leslie Spangler, a researcher at Group Health, a Seattle-based health plan, discovered that antidepressant use in postmenopausal women—those who averaged around 64 years of age—was linked to an increased risk of fractures of the spine and other sites. “Our study didn’t show any strong association between antidepressants and wrist fractures and hip fractures,” she said. “It did find an association with spine fracture.”
In that study, the women taking antidepressants experienced a 30 percent increased risk of spine fracture and a 20 percent increased risk of any type of fracture, according to Spangler. Spangler’s team based its findings on a review of data from over 93,000 women enrolled in the large Women’s Health Initiative Observational Study. For the review, the researchers looked at antidepressant use and then at the incidence of fracture. The study’s findings were published in the May issue of the Journal of General Internal Medicine. In an earlier study, Dr. David Goltzman, director of the McGill Centre for Bone and Periodontal Research at McGill University in Montreal, Canada, reviewed data from an osteoporosis study that included over 5,000 randomly selected people, including 137 who took those antidepressants which are known as selective serotonin reuptake inhibitors—SSRIs—on a daily basis. That research revealed that daily SSRI users had twice the risk of bone fracture as those not taking SSRIs. While the studies suggest an association between antidepressant use and fractures, no research has found a cause-and-effect relationship, Spangler said.
Serotonin is a brain chemical linked to depression and is also involved in the physiology of the bone, said Goltzman, who also said that if you change that system, you can get low bone density, which boosts fracture risk. Goltzman’s research was published in 2007 in the Archives of Internal Medicine. Goltzman reported that he and his colleagues are now looking at teenagers who take SSRIs, to determine if any effects from the drugs on growing bones are revealed and are also looking to see if there is a “genetic predilection” for osteoporosis that’s induced by the antidepressants. Osteoporosis is the brittle bone disease that can lead to fractures.
And from
Medical News Today: Depression And Antidepressants Increase Risk Of Falling In Later Life
Older people have a high risk for falls and the ensuing injuries. This risk, according to an article released on June 17, 2008 in the open-access journal PLoS ONE, is increased by the presence of depression, and increased even more with medication for depression.
Falls are a common problem in seniors, who often have impaired reflexes and strength. As depression is diagnosed, these same patients are often administered medication, including Selective Serotonin Reuptake Inhibitors (SSRIs), which form the most commonly prescribed family of
antidepressants.
According to the published article, depression has been previously correlated with falls: "People with depression and those taking antidepressants, especially SSRIs, are 50% more likely to fall than other older people," said lead author and associate professor Ngaire Kerse. He additionally pointed out the importance of falls in caring for the elderly, as they are "very common and risk factors for falls are easy to identify. "
When examining the data, a correlation was seen between using any antidepressant and falling, but an even higher risk was seen when subjects were using SSRIs, with a 66% increase in falls. In fact, having any degree of depression was assoicated with a 70% increase in risk to have multiple falls and injury. Other relationships were discovered as well, for instance: ever having thought about suicide, having a stroke, having arthritis, or having more than three medical problems were associated with having more than one fall. Finally, women were more likely to sustain injury from a fall than men.
This clearly indicates the need to be aware of this risk when managing the health care of seniors: "Falls are important for all older people," Kerse said. "But in people with depression, falls add to the consequences of depression. There is an opportunity to offer fall prevention strategies as part of the initial treatment for depression in patients and as part of ongoing treatment."
Some of these strategies are recommended by the researchers, including lower leg strengthening and balance retraining. It might also include home assessment and modification programs to reduce hazards, to ensure appropriate lighting, remove obstacles, and install transfer rails, all of which are fall prevention strategies.
They add that family members need to be a part of this treatment.