Long-term use of fluoxetine and multiple skeleton fractures

Abstract

Dear Editor:We report a 33-year-old female patient treated with fluoxetine for 8 years for depression.She had the first depression attack 14 years ago. She was treated with fluoxetine 20 mg/day and used that dose continuously for 5 years. After quitting the medication, her depression returned and fluoxetine was begun at 20 mg/day and increased to 40 mg/day and used at that dose for 3 months, than lowered to the original dose. At the end of 8 years of using fluoxetine 20 mg/day, three fractures occured within a short interval. The first fracture appeared on the right radius and distal third of the ulna. After 8 months, a second fracture at the left distal third of the spinal cruris emerged. One and a half years later, a fragmented fracture was seen at the collum chirurgicum and tuberculum majus in the proximal third of the right humerus. The patient was operated on four times due to those fractures. At the time of the fractures, there were no biochemical abnormalities other than slight elevations in the levels of LH and FSH. The bone densitometry was within normal limits. A poor densitometry rating was found (−1.5) only for the corpus femoris. Based on that finding,

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