Posted by Quintal on August 21, 2007, at 15:36:21
In reply to SSRIs and bone loss, posted by Larry Hoover on August 21, 2007, at 14:56:13
So what is the vitamin D link Lar?
I see this older study found increased risk of hip fracture in all groups taking antidepressants, but the SSRI group had the highest incidence. Interesting, because I get the impression the researchers seem to have set out expecting to find a lower incidence of hip fracture among SSRI users because they are 'better tolerated' (I assume they were thinking sedation and cognitive impairment was the cause of falls, and hence higher incidence of hip fractures, but their results seem to suggest a different mechanism).
__________________________________________________1: Lancet. 1998 May 2;351(9112):1303-7.Click here to read Links
Comment in:
Lancet. 1998 Aug 1;352(9125):400-1; author reply 401-2.
Lancet. 1998 Aug 1;352(9125):400; author reply 401-2.
Lancet. 1998 Aug 1;352(9125):401-2.
Lancet. 1998 Aug 1;352(9125):401; author reply 401-2.Use of selective serotonin-reuptake inhibitors of tricyclic antidepressants and risk of hip fractures in elderly people.
Liu B, Anderson G, Mittmann N, To T, Axcell T, Shear N.Kunin-Lunenfeld Clinical Research Unit, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
BACKGROUND: Tricyclic antidepressants (TCAs) are associated with an increased risk of falls and hip fractures in elderly people. Selective serotonin-reuptake inhibitors (SSRIs) are reported to be better tolerated than TCAs. We investigated the risk of hip fractures associated with SSRIs and TCAs. METHODS: This case-control study used administrative healthcare data from the province of Ontario, Canada. 8239 cases-patients aged 66 years or older, treated in hospital between April, 1994, and March, 1995, for hip fracture-were each matched for age and sex to five controls. Logistic regression was used to calculate the odds ratio for hip fracture with adjustment for potential confounding effects produced by concomitant drug use and comorbidity. FINDINGS: With participants who had no exposure to antidepressants as the reference category, the adjusted odds ratio for hip fracture was 2.4 (95% CI 2.0-2.7) for exposure to SSRIs, 2.2 (1.8-2.8) for exposure to secondary-amine TCAs, and 1.5 (1.3-1.7) for exposure to tertiary-amine TCAs. For all types of antidepressants, current use was associated with a higher risk of hip fracture than former use. The odds ratios for hip fracture were higher for new current users than for continuous current users in all three drug classes. The proportion of current use in the low-dose range was 22% for SSRIs, 50% for secondary-amine TCAs, and 58% for tertiary-amine TCAs. INTERPRETATION: Exposure to any of the three classes of antidepressants is associated with a significant increase in the risk of hip fracture. Despite differences in dose distribution, this analysis suggests that SSRIs do not offer an advantage over TCAs in terms of risk of hip fracture.
PMID: 9643791 [PubMed - indexed for MEDLINE]
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poster:Quintal
thread:777598
URL: http://www.dr-bob.org/babble/20070815/msgs/777606.html