Harvard Women's Health Watch

Exploring the depression-bone connection

A new study finds that antidepressant use doubles fracture risk. Other research points to links between depression and bone loss.

Most of us can tick off the major risk factors for osteoporosis: age, gender, race, family history, smoking, inactivity, low body weight, and inadequate calcium and vitamin D. Depression isn't on the list, but some evidence suggests that it should be. In particular, a study in the Jan. 22, 2007, Archives of Internal Medicine found that people ages 50 and over who regularly took the widely prescribed antidepressants known as selective serotonin reuptake inhibitors (SSRIs) had double the rate of fractures as people not using such medications. Other research points to depression itself as a source of endocrine changes that can damage bone.

Whether the danger comes from depression, the drugs used to treat it, or something else, this is a problem that researchers and clinicians are paying more attention to. The implications for women, particularly older women, are enormous: As many as one woman in 10 suffers from depression, and more than 30 million women ages 50 and over have osteoporosis or are at risk for it. Identifying depression as a risk factor could improve the diagnosis and treatment of this potentially devastating condition.

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