title: Evaluation of the effect of selective serotonin reuptake inhibitors on bone mineral density: an observational cross-sectional study.
abstract: Sixty patients diagnosed with generalized anxiety disorder and treated with either paroxetine, sertraline, or citalopram for at least 12 months were enrolled in this study, and the bone mineral density (BMD) of the patients was compared with that of 40 healthy volunteers. Selective serotonin reuptake inhibitor (SSRI) therapy in generalized anxiety disorder was found to be related with decreased BMD values.
  
  
  BACKGROUND
  The objectives of this study were to evaluate the effect of SSRI therapy on BMD in postmenopausal women diagnosed with generalized anxiety disorder (GAD) and to identify the effects of the duration of disease and treatment on risk factors for osteoporosis.
  
  
  METHODS
  Sixty patients diagnosed with GAD and treated with paroxetine, sertraline, or citalopram from the SSRI group for at least 12 months were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The patients were divided into three groups which are the paroxetine, sertraline, and citalopram groups. The BMD of the patients was compared with that of 40 healthy volunteers.
  
  
  RESULTS
  The L2-L4, total lumbar vertebrae, femoral intertrochanteric, total femoral Z-scores, and femoral Ward's region T-scores of the treatment group were lower than the median T- and Z-scores of the control group (p < 0.05). Of the treatment groups, the femoral neck, trochanteric and intertrochanteric T- and Z-scores, total femoral T- and Z-scores, and femoral Ward's T- and Z-scores of the sertraline group were significantly lower than the BMD values measured at the identical regions in the paroxetine and citalopram groups (p < 0.05).There was a significant negative correlation between the duration of treatment and the BMD values.
  
  
  CONCLUSIONS
  SSRI therapy in GAD was found to be related with decreased BMD values. Further randomized controlled studies are warranted to determine whether SSRI use is a risk factor for osteoporosis; such studies should investigate these factors by performing BMD assessments before treatment.
authors.affiliation: Psychiatry Department, Medical Park Gaziantep Hospital, Gaziantep, Turkey, emine.ak@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Ak
authors.forename: S D
authors.initials: SD
authors.lastname: Bulut
authors.forename: S
authors.initials: S
authors.lastname: Bulut
authors.forename: H A
authors.initials: HA
authors.lastname: Akdağ
authors.forename: G B
authors.initials: GB
authors.lastname: Öter
authors.forename: H
authors.initials: H
authors.lastname: Kaya
authors.forename: O B
authors.initials: OB
authors.lastname: Kaya
authors.forename: C B
authors.initials: CB
authors.lastname: Şengül
authors.forename: C
authors.initials: C
authors.lastname: Kısa
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000188:drug therapy; D015519:Bone Density / Q000187:drug effects*; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced* / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors