Department of Psychiatry and Behavioral Sciences, McGovern Medical School at UTHealth, Houston, TX, USA.
Department of Orthopedic Surgery, McGovern Medical School at UTHealth, Houston, TX, USA.
J Clin Densitom. 2018 Apr-Jun;21(2):193-199. doi: 10.1016/j.jocd.2017.05.016. Epub 2017 Jul 13.
Depression and osteoporosis are 2 common comorbidities in geriatric patients. There are concerns about the deleterious effects of selective serotonin reuptake inhibitor (SSRI) antidepressant use on bone mineral density (BMD). We examined the association between SSRI use and BMD in elderly women (≥65 yr) referred to a geriatric osteoporosis clinic for bone health evaluation. Cross-sectional analyses using the general linear model were performed on data collected retrospectively from August 2010 to April 2015. A total of 250 women were seen during the study period. Of these, 140 women had complete data on BMD measurements: 22 (15.7%) used an SSRI and 118 (84.3%) did not. The 2 groups, SSRI users and SSRI nonusers, did not differ significantly across any of the covariates tested (age, ethnicity, body mass index, and past and present osteoporosis treatment medications). After adjusting for covariates, there was no difference in the BMDs at the femoral neck (p = 0.887) or the spine (p = 0.275) between the 2 groups. Similarly, no difference was seen in the T-scores between SSRI users and nonusers at the femoral neck (p = 0.924) or at the spine level (p = 0.393). Our study did not show an association between SSRI use and BMD among elderly women referred for bone health evaluation. Other studies in the literature have been inconclusive, and therefore, robust longitudinal studies are needed to further assess the interaction between SSRI use and predictors of fracture such as BMD, bone turnover markers, and genes involved in bone turnover. Until then, clinicians should closely monitor the bone health of long-term SSRI users.
抑郁症和骨质疏松症是老年患者的两种常见合并症。人们担心选择性 5-羟色胺再摄取抑制剂（SSRI）抗抑郁药的使用会对骨密度（BMD）产生有害影响。我们研究了在老年女性（≥65 岁）中 SSRI 使用与 BMD 之间的关系，这些女性因骨健康评估而被转介到老年骨质疏松症诊所。使用一般线性模型对 2010 年 8 月至 2015 年 4 月期间回顾性收集的数据进行了横断面分析。在研究期间共观察到 250 名女性。其中，140 名女性的 BMD 测量数据完整：22 名（15.7%）使用了 SSRI，118 名（84.3%）未使用。在测试的任何协变量中，SSRI 使用者和非使用者两组之间没有显著差异（年龄、种族、体重指数以及过去和现在的骨质疏松症治疗药物）。在调整协变量后，两组在股骨颈（p=0.887）或脊柱（p=0.275）的 BMD 无差异。同样，在股骨颈（p=0.924）或脊柱水平（p=0.393），SSRI 使用者和非使用者之间的 T 评分也没有差异。我们的研究未显示在因骨健康评估而被转介的老年女性中 SSRI 使用与 BMD 之间存在关联。文献中的其他研究结果并不一致，因此，需要进行稳健的纵向研究来进一步评估 SSRI 使用与骨折预测因子（如 BMD、骨转换标志物和参与骨转换的基因）之间的相互作用。在此之前，临床医生应密切监测长期使用 SSRI 的患者的骨骼健康。
