title: Selective serotonin reuptake inhibitor use and bone mineral density in women with a history of depression.
abstract: Selective serotonin reuptake inhibitors (SSRIs) are a first-line treatment for depression. They have been reported to regulate serotonin signalling in bone cells and may influence bone metabolism. This study aimed to investigate the effect of SSRIs on bone mineral density (BMD) in a sample of women with a lifetime history of depression. In this community-based study of 607 women, a history of depression was ascertained using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR research version, non-patient edition. BMD was measured at the posterior-anterior (PA) spine, hip, total body and forearm using dual energy absorptiometry, and medication use and lifestyle factors were self-reported. Among 177 women with a lifetime history of depression, current users of bisphosphonates, glucocorticoids, hormone therapy and antidepressants other than SSRIs were excluded. Of the remaining 128 (median age 51.5 years, range 30-74), 26 (20.3%) reported current SSRI use. After controlling for age, weight, height and smoking history, BMD among SSRI users was 5.6% lower at the femoral neck (P=0.03), 6.2% lower at the trochanter (P=0.04) and 4.4% lower at the mid-forearm (P=0.03) than nonusers. No differences in BMD were detected at other sites. Although the mechanism remains unclear, these observations are consistent with a role for the serotonergic system in regulating bone metabolism.
authors.affiliation: Department of Clinical and Biomedical Sciences, Barwon Health, The University of Melbourne, Geelong, Victoria, Australia. lanaw@barwonhealth.org.au
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Henry
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.forename: Felice N
authors.initials: FN
authors.lastname: Jacka
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kotowicz
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nicholson
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D003866:Depressive Disorder / Q000188:drug therapy*; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors