Antidepressant side effects: Is bone loss a concern?

Is it true that antidepressants may cause bone loss?

- Joan / Washington

Answer

This may be true. Two large studies published in July 2007 suggest that older men and women who take selective serotonin reuptake inhibitors (SSRIs), the most common type of antidepressant medication, may have an increased risk of bone loss. Both studies were conducted on men and women age 65 and older.

An earlier study, published in January 2007, reported that people older than age 50 who took SSRIs had a higher risk of bone fractures than did those who didn't take SSRIs. However, more research is necessary to confirm the findings in all three of these studies.

Both depression and osteoporosis are common and serious problems in older adults and should be detected and treated. Mayo Clinic doctors do not recommend that people who have or are at high risk of osteoporosis stop taking antidepressants. Talk to your doctor if you are taking antidepressants and are concerned about your bone health.

You may be able to help reduce bone loss with these tips:

• Get enough calcium. Premenopausal women and postmenopausal women who use hormone therapy (HT) should consume at least 1,000 milligrams (mg) of elemental calcium every day. Postmenopausal women not using HT, anyone at risk of steroid-induced osteoporosis, and all men and women older than age 65 should aim for 1,500 mg of elemental calcium daily.
• Get enough vitamin D. Both men and women should get at least 800 international units (IU) daily.
• Exercise. Combine strength-building and weight-bearing exercises, such as walking, stair climbing and skipping rope, for the best effect.
• Add soy to your diet. The plant estrogens in soy help maintain bone density and may reduce the risk of fractures.
• Don't smoke. Smoking increases bone loss.
• Avoid excess alcohol. Consuming more than two alcoholic drinks a day may decrease bone formation and reduce your body's ability to absorb calcium.
• Consider hormone therapy. HT can reduce a woman's risk of osteoporosis during and after menopause. Ask your doctor about the risks and benefits of HT for menopausal women.

MORE ON THIS TOPIC

• Selective serotonin reuptake inhibitors (SSRIs)
• Antidepressants: Selecting one that's right for you

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