Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;28(1):28-32.
doi: 10.1136/ejhpharm-2019-001893. Epub 2019 May 20.

Effects of selective serotonin reuptake inhibitors and other antidepressant drugs on the risk of hip fracture: a case-control study in an elderly Mediterranean population

Maria Queralt Gorgas  1 , Ferran Torres  2   3 , Roser Vives  4 , Irene Lopez-Rico  1   5 , Dolors Capella  6 , Caridad Pontes  7
Affiliations

Effects of selective serotonin reuptake inhibitors and other antidepressant drugs on the risk of hip fracture: a case-control study in an elderly Mediterranean population

Maria Queralt Gorgas et al. Eur J Hosp Pharm. 2021 Jan.

Abstract

Objectives: To describe the association between exposure to different antidepressant drugs and hip fracture in an elderly Mediterranean population.

Methods: Cases were all patients aged 50-95 years admitted to the emergency room of our hospital with hip fracture not related to a high intensity trauma during 2010. For each case, four controls were identified from primary care electronic medical records matched by age (±3 years), gender, date of consultation at the primary care centre (±1 month) and primary care centre. Pharmacological treatments received within the previous 5 years were retrieved from the prescription records. Crude and adjusted risks associated with exposures were calculated by conditional logistic regression. ORs were adjusted by matching variables and by significant risk factors identified in the bivariate analysis (prescription of ≥4 drugs, osteoporosis, diabetes mellitus and previous fracture).

Results: 136 cases and 544 controls were analysed. Adjusted OR (95% CI) for hip fracture associated with exposure to any antidepressants was 2.42 (1.24 to 4.73); for selective serotonin reuptake inhibitors (SSRIs) it was 3.52 (1.67 to 7.41), for non-selective monoamine reuptake inhibitors 1.07 (0.18 to 6.46) and for other antidepressants 0.82 (0.27 to 2.48). Sertraline (OR 3.88 (1.15 to 13.09)) was the only active principle with significant adjusted risk. When only exposures >6 months were considered, significant risks persisted for SSRIs (OR 2.64 (1.10 to 6.37)).

Conclusions: The results of this study are coincident with other studies in which SSRIs, but not other types of antidepressants, are associated with an increased risk of hip fracture in our setting.

Keywords: antidepressant; case control study; fracture; osteoporosis; selective serotonin reuptake inhibitors.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Selection of patients and controls. *Other locations than hip.
See this image and copyright information in PMC

References

    1. Rabenda V, Nicolet D, Beaudart C, et al. . Relationship between use of antidepressants and risk of fractures: a meta-analysis. Osteoporos Int 2013;24:121–37. 10.1007/s00198-012-2015-9 - DOI - PubMed
    1. Van den Brand MW, Pouwels S, Samson MM, et al. . Use of anti-depressants and the risk of fracture of the hip or femur. Erratum in Osteoporosis Int 2009; 20:1715. Osteoporos Int 2009;20:1705–13. - PMC - PubMed
    1. Ensrud KE, Blackwell T, Mangione CM, et al. . Central nervous system active medications and risk for fractures in older women. Arch Intern Med 2003;163:949–57. 10.1001/archinte.163.8.949 - DOI - PubMed
    1. Tsapakis EM, Gamie Z, Tran GT, et al. . The adverse skeletal effects of selective serotonin reuptake inhibitors. European Psychiatry 2012;27:156–69. 10.1016/j.eurpsy.2010.10.006 - DOI - PubMed
    1. Warden SJ, Robling AG, Haney EM, et al. . The emerging role of serotonin (5-hydroxytryptamine) in the skeleton and its mediation of the skeletal effects of low-density lipoprotein receptor-related protein 5 (LRP5). Bone 2010;46:4–12. 10.1016/j.bone.2009.06.029 - DOI - PMC - PubMed

Publication types

Substances