Selective serotonin reuptake inhibitor treatment and risk of fractures: a meta-analysis of cohort and case–control studies

Wu, Qing; Bencaz, Angelle F.; Hentz, Joseph G.; Crowell, Michael D.

doi:10.1007/s00198-011-1778-8

Cited by 133 publications

(117 citation statements)

References 46 publications

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“…Two recent meta-analyses confirmed this association [Wu et al 2012;Eom et al 2012;Rabenda et al 2013]. Eom and colleagues calculated the adjusted OR for fracture among SSRI users to be 1.69 (95% CI 1.51-1.90; r 2 = 89.9%) [Eom et al 2012], while Wu and colleagues found a similar OR of 1.73 (95% CI 1.51-1.9; p < 0.001) [Wu et al 2012]. Fracture risk was highest at the hip and nonvertebral sites compared with the spine [Rabenda et al 2013].…”

Section: Selective Serotonin Reuptake Inhibitorssupporting

confidence: 48%

“…Serotonin receptors found on osteoblasts and osteoclasts regulate bone homeostasis via endocrine, autocrine, paracrine, and neuronal serotonin pathways. Surprisingly, SSRI exposure related fractures occur in the absence of declines in BMD, indicating that SSRIs likely have alternative effects on bone homeostasis [Wu et al 2012]. …”

Section: Selective Serotonin Reuptake Inhibitorsmentioning

confidence: 99%

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Medication-induced osteoporosis: screening and treatment strategies

Panday

Gona

Humphrey

2014

Therapeutic Advances in Musculoskeletal

145

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Drug-induced osteoporosis is a significant health problem and many physicians are unaware that many commonly prescribed medications contribute to significant bone loss and fractures. In addition to glucocorticoids, proton pump inhibitors, selective serotonin receptor inhibitors, thiazolidinediones, anticonvulsants, medroxyprogesterone acetate, aromatase inhibitors, androgen deprivation therapy, heparin, calcineurin inhibitors, and some chemotherapies have deleterious effects on bone health. Furthermore, many patients are treated with combinations of these medications, possibly compounding the harmful effects of these drugs. Increasing physician awareness of these side effects will allow for monitoring of bone health and therapeutic interventions to prevent or treat drug-induced osteoporosis.

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Section: Selective Serotonin Reuptake Inhibitorssupporting

confidence: 48%

Section: Selective Serotonin Reuptake Inhibitorsmentioning

confidence: 99%

Medication-induced osteoporosis: screening and treatment strategies

Panday

Gona

Humphrey

2014

Therapeutic Advances in Musculoskeletal

145

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“…In a meta-analysis of 13 studies conducted by Wu et al (12), the use of SSRIs has been associated with an elevated rate of fractures. This association was also seen in studies that had adjusted for bone mineral density and depression (12). These findings suggest a connection or a common pathway of serotonin and leptin.…”

Section: Introductionsupporting

confidence: 52%

MECHANISMS IN ENDOCRINOLOGY: The endocrine role of the skeleton: background and clinical evidence

Schwetz

Pieber²,

Obermayer-Pietsch

2012

European Journal of Endocrinology

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Based on the observation that diabetes, obesity, and hypogonadism influence bone metabolism, the existence of a feedback loop and a common regulation was postulated and an endocrine role ascribed to the skeleton. In the first part of this review, two pathways are described whereby adipose tissue acts on bone mass. In the first, leptin activates the sympathetic nervous system via serotonin and diminishes bone mass accrual. The second pathway functions via the activation of CART (CARTPT) and inhibits bone resorption. The first pathway leads to a decrease in bioactivity of the osteoblast-produced hormone osteocalcin (OC) (part 2). In its undercarboxylated form, OC acts on the three targets pancreas, adipose tissue, and gonads (part 3) and thereby causes an increase in insulin secretion and sensitivity, b-cell proliferation, and male fertility. Insulin (part 4) is part of a recently discovered regulatory feedback loop between pancreas and osteoblasts. It is a strong counterplayer of leptin as it causes a decrease in OPG expression and enhances bone resorption and OC decarboxylation. Numerous clinical studies (part 5) have shown associations of total and undercarboxylated OC and markers of energy metabolism. Interventional studies, to date only performed in murine models, have shown positive effects of OC administration on energy metabolism. Whether bone tissue has an even further-reaching endocrine role remains to be elucidated. European Journal of Endocrinology 166 959-967

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“…Analizirajući 19 objavljenih studija, jedan pregledni članak i jednu meta analizu, Sansone sugeriše da antidepresivi imaju negativne efekte na kost, delimično smanjujući gustinu ili povećavajuči rizik od preloma, te da bi serotonin mogao imati važnu regulatornu ulogu u modelovanju kosti [41]. Wu i saradnici [42] su na osnovu meta analize 13 kvalifikovanih kohortnih i case-control studija takođe sugerisali da postoji značajno povećanje rizika od preloma kod pacijenata koji su na terapiji SSRI antidepresivima.…”

Section: Antidepresiviunclassified

“…Ne postoji zvanična preporuka za prevenciju osteoporoze kod ovih pacijenata, ali svakako bi trebalo napraviti pravi izbor odgovarajuće grupe lekova u lečenju depresije u odnosu na starost, početni status skeleta pacijenta, a naročito kod osoba koje već imaju osteoporozu, ili su već imale osteoporotične frakture, ili imaju druge poznate faktore rizika [42,43].…”

Section: Antidepresiviunclassified

Osteoporoza prouzrokovana lekovima

Nestorović¹,

Rašić

Hudomal

et al. 2013

Biomedicinska istraž.

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2 Institut za farmakologiju i toksikologiju, Medicinski fakultet Priština sa sedištem u Kosovskoj Mitrovici, Srbija 3 Institut za patofiziologiju, Medicinski fakultet Priština sa sedištem u Kosovskoj Mitrovici, Srbija Kratak sadržajSve je veći broj istraživanja koja otkrivaju da mnogi lekovi ispoljavaju neže-ljene efekte na mineralnu gustinu i strukturu koštanog tkiva. Brojne studije su pokazale da neki lekovi mogu biti "štetni za kost" kao što su: glukokortikoidi, hormoni štitaste žlezde, antiepileptici, antidepresivi, aromatični inhibitori, gonadotropin oslobađajući agensi, kontraceptivi, antiretrovirusni lekovi, diuretici Henleove petlje, inhibitori protonske pumpe (IPP) i drugi. Uravnoteženi balans u primeni lekova za vreme dugotrajne terapije izazovan je i zahtevan posao lekara u primarnoj i sekundarnoj praksi i zavisi od njihove upućenosti o odnosu između koristi i štetnosti primenjenih medikamenata. Određivanje statusa skeleta pacijenta pre započinjanja terapije nekim od tzv. "lekova štetnih za kost", veoma je važno i omogućava individualan pristup u terapiji.Ključne reči: osteoporoza, dugotrajna medikacija, "lekovi štetni za kost" UvodKost čini osnovnu potporu ljudskom telu i za održavanje njene homeostaze mora postojati ravnoteža između stvaranja i razgradnje koštanog tkiva. Gustina i mikroarhitektonska struktura kostiju se tokom života menjaju i zavise od mnogih faktora. Poznato je da se svakih osam do deset godina koštano tkivo čitavog skeleta fiziološki zameni.Osteoporoza predstavlja sistemski poremećaj skeleta nastao kao posledica gubitka koštane mase [1] i mikroarhitekture kostiju, čije su najteže komplikacije prelomi. Ona je zapravo posledica disbalansa u remodelovanju kosti na račun pojačanih kataboličkih procesa (pojačana funkcija osteoklasta, a smanjena osteoblasta). Uobičajeno je da se mineralna gustina kostiju određuje dvostrukim rentgen-apsorpcionim (DXA) osteodenzimetrima pri čemu je bitno odrediti i broj odstupanja (SD) od srednjih vrednosti (DXA T-score), naročito za mlađe

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Selective serotonin reuptake inhibitor treatment and risk of fractures: a meta-analysis of cohort and case–control studies

Abstract: Use of SSRIs is associated with increased risk of fracture. The SSRIs may exert an increased risk of fracture independent of depression and bone mineral density.

Cited by 133 publications

References 46 publications

Medication-induced osteoporosis: screening and treatment strategies

Medication-induced osteoporosis: screening and treatment strategies

MECHANISMS IN ENDOCRINOLOGY: The endocrine role of the skeleton: background and clinical evidence

Osteoporoza prouzrokovana lekovima

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