LADR Zentrallabor Dr. Kramer & Kollegen, Lauenburgerstr. 67, D-21502 Geesthacht, Germany.
Department of Psychiatry and Psychotherapy, Medical School, Lübeck University, Ratzeburger Allee 160, D-23538 Lübeck, Germany.
Int J Environ Res Public Health. 2018 Jun 30;15(7):1373. doi: 10.3390/ijerph15071373.
Antidepressive agents are one of the fastest-growing classes of prescribed drugs. However, the effects of antidepressive agents on bone density are controversial. The aim of this meta-analysis is to evaluate the state of research on the relationship between the use of tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) and bone mineral density (BMD) in women. The database searched was Pubmed. The meta-analysis included human studies in women fulfilling the following criteria: (i) an assessment of bone mineral density in the lumbar spine, the femoral neck or the total hip; (ii) a comparison of the BMD of depressed individuals using antidepressive agents (SSRIs or TCAs), and a control group that did not use antidepressive agents; (iii) measurement of BMD using dual-energy X-ray absorptiometry (DXA); and (iv) calculations of the mean BMD and standard deviation or standard error. Four studies were identified, which, in total, included 934 women using antidepressive agents and 5767 non-using individuals. The results showed that no significant negative composite weighted mean effect sizes were identified for the comparisons between SSRI users and non-users. Similarly, no significant negative composite weighted mean effect sizes were identified for the comparisons between TCA users and non-users, indicating similar BMD in SSRI or TCA users and non-users. The meta-analysis shows that the association between antidepressant medication and bone mineral density has not been extensively researched. Only four studies fulfilled the inclusion criteria. The global result of the literature review and meta-analysis was that the use of antidepressive agents was not associated with lower or higher BMD. This result applies to both SSRIs and TCAs and to all measurement locations (lumbar spine, femoral neck and total hip).
抗抑郁药是增长最快的处方药之一。然而，抗抑郁药对骨密度的影响存在争议。本荟萃分析的目的是评估三环类抗抑郁药（TCAs）或选择性 5-羟色胺再摄取抑制剂（SSRIs）与女性骨密度（BMD）之间关系的研究现状。检索的数据库是 Pubmed。荟萃分析包括符合以下标准的女性人类研究：（i）评估腰椎、股骨颈或全髋的骨矿物质密度；（ii）比较使用抗抑郁药（SSRIs 或 TCAs）的抑郁个体的 BMD 与未使用抗抑郁药的对照组；（iii）使用双能 X 射线吸收法（DXA）测量 BMD；（iv）计算平均 BMD 和标准差或标准误差。确定了四项研究，这些研究总共包括 934 名使用抗抑郁药的女性和 5767 名未使用的个体。结果表明，SSRI 使用者与非使用者之间的比较没有显著的阴性综合加权平均效应大小；同样，TCA 使用者与非使用者之间的比较也没有显著的阴性综合加权平均效应大小，表明 SSRI 或 TCA 使用者与非使用者的 BMD 相似。荟萃分析表明，抗抑郁药物与骨密度之间的关联尚未得到广泛研究。只有四项研究符合纳入标准。文献综述和荟萃分析的总体结果是，使用抗抑郁药物与较低或较高的 BMD 无关。这一结果适用于 SSRIs 和 TCAs 以及所有测量部位（腰椎、股骨颈和全髋）。
