The Pharmaceutical Journal
Vol 278 No 7436 p100
27 January 2007

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SSRIs associated with two-fold fracture risk

Daily use of selective serotonin reuptake inhibitors (SSRIs) in adults over the age of 50 years is associated with a two-fold increased risk of some fractures, according to Canadian researchers. Adjustment for potential confounding variables did not remove this risk.

The researchers recorded data on incident fractures among 5,008 adults living in the community, of whom 137 reported daily SSRI use. As well as being associated with an increased risk of fracture (hazard ratio 2.1, 95 per cent confidence interval 1.3–3.4), daily SSRI use was associated with increased risk of falls and decreased bone mineral density. These effects were dose-dependent.

“Our results suggest that BMD and falls may be affected adversely by daily SSRI use but that fracture rates remain elevated despite adjustment for these two risk factors, indicating that other pathways, such as impaired bone quality leading to reduced bone strength, may be of particular relevance,” the authors conclude (Archives of Internal Medicine 2007;167:188).