Antidepressant Bone Fracture Risk Seen for Post-Menopausal Women: Study

The findings of new research suggest that side effects of antidepressants like Zoloft, Paxil, Celexa and Prozac may increase the risk of bone fractures when used by women who have gone through menopause. 

In the latest edition of the medical journal Injury Prevention, researchers from Harvard and University of North Carolina Chapel Hill warn that a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may alter bone turnover among post-menopausal women, increasing the risk of bones thinning and fracturing.

SSRIs are a common class of antidepressant drug, used to treat depression and anxiety disorders. They are among the most widely used drugs in the United States.

Researchers looked at data on 137,031 women between the ages of 40 and 64 who began taking SSRIs between 1998 and 2010. Data on women who took Celexa, Lexapro, Paxil, Zoloft, Prozac, and Luvox were compared to nearly a quarter million others who took proton pump inhibitors, such as Nexium, or an H2 agonists, like Zantac and Tagamet.

The study found that women who took SSRIs faced a 76% higher bone fracture risk after taking the drug just one year when compared to women who took the other types of drugs. After two years, the risk was 73% higher, and 67% higher after five years of use.

Researchers said their findings indicate that shorter duration of treatment may decrease the risk of bone fractures. They also called for more investigations into the risk of SSRI bone fractures, particularly at low doses.

Other SSRI Side Effects

These concerns over SSRI antidepressant use by post-menopausal women come amid a number of other health risks associated with the popular medications in recent years.

In 2012, research in Canada found antidepressants like Zoloft and Celexa increased a patients risk for life-threatening brain bleeds by nearly 50%.

Other research published in the British Medical Journal earlier this year linked certain SSRIs, Celexa and Lexapro, to an increased risk of abnormal heart rhythms, a side effect which the FDA warned the public about in 2011.

Other side effects of the SSRI drug class span beyond blood and heart problems and include increased risk of death for ICU patients and higher risk of giving birth to an autistic child.

One study conducted by researchers in the U.S. and Canada suggested that antidepressant side effects may outweight the benefits, concluding that SSRI drugs may do more harm than good for patients.

SSRI Birth Defect Risks

Other studies have suggested potential risks associated with continuing to use SSRI antidepressants while pregnant, including a potential connection with the development of birth defects and malformations among children exposed to the drugs in utero.

In a study published in the British Medical Journal (BMJ) in January 2014, Canadian researchers found that SSRI antidepressants were associated with an increased risk of children being born with persistent pulmonary hypertension in newborns (PPHN).

The risk increased the later during pregnancy that the drug was used, according to the results, which argues for taking women off the drugs either before they plan to become pregnant or as soon as they find out that they are pregnant.

PPHN is a rare birth defect that results in babies being unable to adapt to breathing outside of the womb. They frequently require intensive care and the use of a mechanical ventilator to help them breathe. Severe cases of PPHN can result in multiple organ damage, brain damage and death.

In December 2011, the FDA issued a drug safety communication warning about the link between SSRI pregnancy use and PPHN. However, the federal drug regulators said that there was conflicting data and said the association was unclear. That was a rollback of a 2006 warning by the FDA, which indicated that pregnancy exposure to SSRIs were associated with an increased risk of PPHN.

Several years ago, GlaxoSmithKline faced hundreds of lawsuits over Paxil birth defects linked to PPHN, and the drug maker has settled most of those cases.

Now, Pfizer faces hundreds of Zoloft birth defect lawsuits from parents who say the company failed to warn them that taking the drug during pregnancy placed their unborn children at risk of PPHN and other severe health problems that are allegedly caused by use of the antidepressant during pregnancy.

Zoloft (sertraline) is one of the most widely prescribed medications in the United States, and has been used by tens of millions of individuals. However, use of Zoloft by pregnant women has been linked to a potential increased risk of serious and potentially life-threatening birth defects and malformation for children.

In November 2006, the FDA added warnings about a potential risk of PPHN from Zoloft and other newer antidepressants when taken after the 20th week of pregnancy. The side effects of Zoloft and other similar medications were linked to a six times greater risk of PPHN.

In June 2007, studies found an association between the use of antidepressants like Zoloft early in the pregnancy and a risk of abnormal skull development, gastrointestinal abnormality and brain defects.

In September 2009, another study published in the British Medical Journal found that SSRI antidepressants like Zoloft increase the risk of heart defects when taken during the first trimester, a time when many women do not even know they are pregnant.