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Bone fracture rate higher in women who use SSRIs to ease menopause symptoms

Women who take selective serotonin reuptake inhibitors (SSRIs) to manage menopausal symptoms may have an increased risk of bone fracture.

SSRIs are a first-line treatment for depression, but have been approved recently by the United States Food and Drug Administration for the treatment of vasomotor menopausal symptoms, including hot flashes and night sweats.

Researchers set out to discover whether the heightened risk of bone fracture found in people with psychiatric disorders who take the medication also applied to women prescribed SSRIs for menopausal symptoms.

They drew on the PharMetrics Claims Database, which contains detailed information on medical and drug treatment claims in the US, to study 137,031 women with no mental health issues and aged between 40 and 64, who started treatment with SSRIs between 1998 and 2010. They were compared with more than 236,000 women of the same age range who were prescribed H2 antagonists or proton pump inhibitors, typically used to treat indigestion, over the same time period.

The fracture rate among those prescribed SSRIs was 76% higher one year after starting treatment, 73% higher after two years, and 67% higher after five years than it was among those treated with indigestion drugs.

The observational study does not prove cause and effect. Nevertheless, the researchers suggest that shorter duration of treatment might mitigate the cumulative risk of excess fractures.

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