Selective serotonin reuptake inhibitors, also known as SSRIs, are a class of antidepressant drugs that are given to millions of Americans each year, but sometimes these drugs are given to people for other medical conditions. One of the medical conditions that SSRIs are given for besides depression is menopause, since SSRIs can help curb the symptoms associated with the “change” that women go through in their later years. A new study published in the journal Injury Prevention has come out though, which states women who are in menopause and taking SSRIs are at a higher risk of developing bone fractures.
The findings from the study are showing that the elevated risk of developing bone fractures can last for several years, which has prompted the researchers of the study to suggest that doctors need to think about shortening the length of time they put their older female patients on the SSRIs. More studies will need to be done however to see if the same results and associations are found using lower doses of the SSRI drugs the researchers said. In the United States, SSRI medications have become the third most prescribed class of drugs, and often times they are being prescribed for disorders that are not psychiatric in nature. These other conditions that are being treated with SSRI medications include irritable bowel syndrome, and symptoms associated with menopause such as hot flushes and night sweats. SSRIs have become a more effective treatment these days than hormone replacement therapy, also known as HRT, since they have less risks and side effects.
The researchers wanted to know if SSRIs were associated with heightened risk of bone fractures among middle-aged women prescribed them due to menopausal symptoms, since there have been studies that have established psychiatric disorders have been linked to an increased fracture risk. The researchers used the PharMetrics Claims Database for the study, which provides detailed information on medical and drug treatment claims from over 61 million patients in more than 98 managed care plans throughout the United States. The researchers keyed in on 137,031 women who did not have mental health issues and were between 40 and 64 years of age. These women had started SSRI treatment between 1998 and 2010. The SSRIs included citalopram, hyrdrobromide, escitalopram oxalate, fluoxetine hyrdrochloride, fluvoxamine maleate, paroxetine hydrochloride and sertraline hydrochloride.
Those results were then compiled with over 236,294 women of the same age who were prescribed H2 antagonists or proton pump inhibitors, which are used to often treat indigestion, and this was over the same time frame. The data analysis showed that the fracture rates were significantly higher in the women who were being treated with the SSRI medications. Specifically, the fracture rate was 76 percent higher in the group of women who were prescribed the SSRI medications one year after starting the treatment. The rate went to a 73 percent increase 2 years after, and 67 percent increase after 5 years when being compared to the women who were being treated with indigestion medication.
While the results of the study seem fairly indicative and certain, this is an observational study, which means that no definitive conclusions can be drawn from the results of the study. The researchers say that while you can’t prove cause and effect, there is a previous study that showed a theory to explain the associations that they found during their study. The researchers suggest that the antidepressant medication is altering the bone turnover, which shifts the balance towards thinning of the bones rather than strengthening of the bones.
The SSRI medication seems to increase the fracture risk among the middle-aged women without the psychiatric disorders, which is sustained over a period of time, and this means that shorter durations of treatment could decrease the fracture risk. There is likely going to be even more women that go on SSRI medication to help menopausal symptoms in the future due to the United States giving SSRI medications the green light to be used for menopausal symptoms. This really means that women need to only be on the SSRI medications for short spurts or when symptoms of menopause get really bad, and doctors need to be aware of the possible long-term negative consequences of SSRI medications. There are a lot of women who end up going through menopause for many years, so it’s important that women only look to SSRI medications when the symptoms get so bad that they cannot sustain a normal quality of life, especially if they are older or have a history in the family of osteoporosis or other bone diseases.