title: The association between use of antidepressants and bone quality using quantitative heel ultrasound.
abstract: OBJECTIVE
  Osteoporosis and depression are major public health problems worldwide. Studies have reported an association between antidepressant use, mainly selective serotonin reuptake inhibitors (SSRIs), and bone mineral density (BMD), but the issue remains unclear.
  
  
  METHODS
  This study examined data collected from 849 Australian men (aged 24-98 years) participating in the Geelong Osteoporosis Study (GOS). Bone quality was determined using quantitative ultrasound (QUS) and included the following parameters: Broadband Ultrasound Attenuation (BUA), Speed of Sound (SOS) and Stiffness Index (SI). Anthropometry, socio-economic status (SES), medication use and lifestyle factors were determined. The cross-sectional associations between bone quality and use of antidepressants were studied using multivariate linear regression adjusted for potential confounders.
  
  
  RESULTS
  At the time of assessment, 61 (7.2%) men were using antidepressants, of which 44 (72.1%) used SSRIs. Antidepressant use was associated with lower SI (p = .002), SOS (p = .010) and BUA (p = .053). However, body weight was identified as an effect modifier; QUS values were lower for antidepressant users with lower weight (< 90 kg) only.
  
  
  CONCLUSIONS
  Use of antidepressants was associated with lower QUS values for men with low body weights. Thus, the risk of osteoporosis should be taken into account when prescribing antidepressants, in particular among men who are in this weight category.
authors.affiliation: Social Pharmacy, School of Pharmacy, University of Eastern Finland (UEF), Kuopio, Finland Bone and Cartilage Research Unit, Institute of Clinical Medicine, UEF, Kuopio, Finland.
authors.forename: Päivi H
authors.initials: PH
authors.lastname: Rauma
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia North West Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Australia.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Stuart
authors.affiliation: Institute of Clinical Medicine, Psychiatry, UEF, Kuopio, Finland Departments of Psychiatry, Kuopio University Hospital, South-Savonia Hospital District, Mikkeli; North Karelia Central Hospital, Joensuu; SOSTERI, Savonlinna; SOTE, Iisalmi; Lapland Hospital District, Rovaniemi, Finland.
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.affiliation: Bone and Cartilage Research Unit, Institute of Clinical Medicine, UEF, Kuopio, Finland.
authors.forename: Risto J
authors.initials: RJ
authors.lastname: Honkanen
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia Barwon Biomedical Research, The Geelong Hospital, Geelong, Australia.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Hodge
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia lanaw@barwonhealth.org.au.
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001315:Australia; D001835:Body Weight; D015519:Bone Density / Q000187:drug effects*; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy*; D005500:Follow-Up Studies; D006365:Heel / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000175:diagnosis*; D057566:Self Report; D014463:Ultrasonography
chemical_list: D000928:Antidepressive Agents
keywords: antidepressants; bone mineral density; bone quality; osteoporosis; selective serotonin reuptake inhibitors