Posted by Quintal on August 21, 2007, at 20:20:21
In reply to Re: depression and bone loss, posted by Quintal on August 21, 2007, at 20:16:00
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1: Med Hypotheses. 2001 Oct;57(4):469-71.Click here to read Links
Selective serotonin-reuptake inhibitor antidepressants increase the risk of falls and hip fractures in elderly people by inhibiting cardiovascular ion channels.
Pacher P, Ungvari Z.Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. ppacher@hotmail.com
Surprising results from recently published retrospective studies show that the use of new selective serotonin-reuptake inhibitor antidepressants (SSRIs), similarly to the older tricyclic antidepressants (TCAs), increases the risk of falls and hip fractures among elderly people.The mechanism whereby antidepressants increase this risk is complex and may include orthostatic hypotension, arrhythmias, sedation and confusion. The increased risk of falls and hip fractures with the use of TCAs is not surprising considering their well-known cardiovascular, anticholinergic and antihistaminergic side-effects. But the increased risk of falls with SSRIs is highly unexpected since these drugs are believed to be free from the disadvantages of TCAs.We hypothesized that the new SSRI antidepressants may also have cardiovascular effects similarly to the older TCA compounds, which may be an explanation for the increased rate of falls and hip fractures. The experimental and clinical evidence in support of this hypothesis are discussed. Copyright 2001 Harcourt Publishers Ltd.
PMID: 11601871 [PubMed - indexed for MEDLINE]
--------------------------------------------------: Am J Epidemiol. 2003 Jul 1;158(1):77-84.Click here to read Links
Exposure to tricyclic and selective serotonin reuptake inhibitor antidepressants and the risk of hip fracture.
Hubbard R, Farrington P, Smith C, Smeeth L, Tattersfield A.Division of Respiratory Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, England. Richard.hubbard@nottingham.ac.uk
The use of tricyclic antidepressants is associated with an increased risk of hip fracture. Despite a better side effect profile, this adverse effect has also been reported for selective serotonin reuptake inhibitors. To determine whether these findings result from bias arising from the case-control method, the authors have performed a case-control analysis and a self-controlled case-series analysis using 1987-1999 diagnosis data for 16,341 cases of hip fracture and 29,889 controls drawn from the United Kingdom General Practice Research Database. Both analyses showed an association between hip fracture and antidepressant treatment, and this was most marked during the first 15 days of treatment. The estimates from the case-control study were larger than those from the case-series analysis: The odds ratios for fracture within the first 15 days of a prescription for tricyclic antidepressants and serotonin reuptake inhibitors were 4.76 (95% confidence interval (CI): 3.06, 7.41) and 6.30 (95% CI: 2.65, 14.97), whereas the equivalent incidence ratios were 2.30 (95% CI: 1.82, 2.90) and 1.96 (95% CI: 1.35, 2.83). Tricyclic antidepressants and serotonin reuptake inhibitors are both associated with an independent increase in hip fracture incidence during the first weeks of treatment. The estimates from the case-series analyses were smaller than those from the case-control analyses, suggesting that the case-control method is subject to bias.
PMID: 12835289 [PubMed - indexed for MEDLINE]
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poster:Quintal
thread:777598
URL: http://www.dr-bob.org/babble/20070815/msgs/777679.html