title: Opioids, antiepileptic and anticholinergic drugs and the risk of fractures in patients 65 years of age and older: a prospective population-based study.
abstract: BACKGROUND
  in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied.
  
  
  OBJECTIVE
  the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug.
  
  
  METHODS
  this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports.
  
  
  RESULTS
  at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females.
  
  
  CONCLUSIONS
  the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.
authors.affiliation: Department of Family Medicine, University of Turku, Lemminkäisenkatu 1 20014, Turku, Finland. janurm@utu.fi
authors.forename: Janne
authors.initials: J
authors.lastname: Nurminen
authors.forename: Juha
authors.initials: J
authors.lastname: Puustinen
authors.forename: Maarit
authors.initials: M
authors.lastname: Piirtola
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.forename: Alan
authors.initials: A
authors.lastname: Lyles
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Kivelä
mesh_terms: D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000927:Anticonvulsants / Q000009:adverse effects*; D016009:Chi-Square Distribution; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D005260:Female; D005387:Finland / Q000453:epidemiology; D050723:Fractures, Bone / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019338:Polypharmacy; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D000927:Anticonvulsants; D018680:Cholinergic Antagonists