Depression and Osteoporosis
June 1, 2007
Antidepressant use may boost
fracture risk, from Harvard Women’s
Health Watch
BOSTON — Evidence is accumulating
that depression is a risk factor for osteoporosis,
reports the June 2007 issue of Harvard Women’s
Health Watch. A recent study found that people
ages 50 and over who regularly took antidepressants
called 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, doctors are paying
more attention to this association. During the 1990s,
depression began to emerge as a possible cause of bone
loss, rather than a result. Scientists studied women
who didn’t have osteoporosis symptoms or even
know they had the condition. They found lower bone
mineral density in those who were depressed. Moreover,
the link was found in both younger women and women
past menopause. Other studies have found a similar
relationship, so investigators have been looking at
hormones and brain chemicals potentially involved in
both depression and bone loss.
Researchers working with an animal model found that
depression triggers the release of noradrenaline, which
interferes with bone-building cells. Moreover, they
found that imipramine — a member of an older
class of drugs called tricyclic antidepressants — reversed
both depression and depression-induced bone loss.
It may be a long time before the depression-osteoporosis
connection is fully clarified. In the meantime, Harvard
Women’s Health Watch suggests that you continue
taking an antidepressant if you already use one; depression
is a serious illness that can have profound consequences.
You may also want to talk to your doctor about getting
a bone density test, and make sure you get adequate
calcium.
Also in this issue:
- Update on treating IBS
- Driving safety and aging
- Simpler CPR for cardiac arrest
- By the way doctor: Tamoxifen versus aromatase inhibitors
for breast cancer
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