Common Antidepressants Linked to Higher Fracture Odds in Menopausal Women

Women prescribed a common class of antidepressants to ease menopausal symptoms may face a long-term rise in theirs for bone fracture, a new study suggests.

The antidepressants in question are selective serotonin eruptive inhibitors (SSRI) medications such as Celexa, Paxil, Prozac and Zoloft.

Besides being used to treat depression, these drugs are often prescribed as an alternative to hormone replacement therapy (HRT) to tackle hot flashes, night sweats and other problems that can accompany menopause.

However, “SSRIs appear to increase fracture risk among middle aged women without psychiatric disorders,” wrote a team led by Dr. Matthew Miller of Northeastern University in Boston.

The team added that the effect seems to be “sustained over time, suggesting that shorter duration of treatment may decrease [this effect].”

Findings from the study were published June 25 in the journal Injury Prevention.

Researchers sifted through data from the PharMetrics Claims Database, which collects information on drug treatments involving roughly 61 million patients nationally. They focused on more than 137,000 women between the ages of 40 and 64, all of whom began SSRI treatment at some point between 1998 and 2010.

They found that women in the SSRI group faced a 76% higher risk for fracture after a single year of SSRI use, compared with the non-SSRI group.



One expert in bone health said a relationship between SSRIs and bone weakening does have some basis in biology.

“The authors speculate that the mechanism of action involves the activation of osteoclasts, cells which break down bone, by the SSRIs,” explained Dr. Caroline Messer, an endocrinologist at Lenox Hill Hospital in New York City.

She said that, “While more studies are needed, the trial does suggest that women might want to limit the duration of treatment with SSRIs and perhaps consider taking the lowest effective dose to minimize bone loss.”

My Take:
Altering brain chemistry by preventing the body from dismantling serotonin has body wide effects. Stimulation of the osteoclasts resulting in bone loss, osteoporosis, and ultimately increased bone fractures will not be the only side effect from this class of drugs. They are only effective in treating depression about a third of the time and I suspect this off label use for menopausal symptoms will create significant health issues.

I can’t help but wonder how many women are taking SSRIs in combination with biphosphonates, like Fosamax which inhibit osteoclastic activity. That would really confuse the chemistry of the body.

The Bottom Line:
Please avoid the use of SSRIs in the treatment of menopausal symptoms. There are several herbs that are quite effective in reducing or eliminating symptoms during this transitional period.

Source: June 26, 2015 National Institutes of Health