Serotonergic antidepressant use and the risk of fracture: a population-based nested case–control study

Abstract

Current use of SSRI/SNRI is associated with an increased risk of all caused fractures. Additionally, the co-morbidity, especially osteoporosis and a history of falling, plays an important role in the risk of fractures.

Selective serotonin reuptake inhibitor and selective serotonin and norepinephrine reuptake inhibitor use and risk of fractures in adults: A systematic review and meta‐analysis

“…No relevant randomized controlled studies were found. Sixteen studies were included from the previous systematic review, and 17 studies were identified as new in the databases (Figure ) …”

“…The studies we found were published between 1998 and 2016, with 11 studies since 2013 . Two studies were reported across multiple articles and each was treated as a single distinct study: Vestergaard et al and Souverein et al One study reported results from both a cohort and a nested case‐control analysis .…”

“…Data on SSRI and SNRI use were retrieved either from the national prescription database or self‐reported and verified from drug containers. Thirteen studies categorized participants into current, recent, or past users …”

“…Where more than one effect estimate was reported for any outcome, the most stringently adjusted estimate was selected. Estimates of fracture risk for current and past SSRI and/or SNRI use were extracted separately, and an estimate of current use was used in a meta‐analysis to derive an overall estimate across studies . For studies where multiple levels of DDD were investigated, results for the level closest to one DDD were selected .…”

“…Estimates of fracture risk for current and past SSRI and/or SNRI use were extracted separately, and an estimate of current use was used in a meta‐analysis to derive an overall estimate across studies . For studies where multiple levels of DDD were investigated, results for the level closest to one DDD were selected . The primary outcome was fracture at any of the anatomical sites assessed in a study, which in most cases included multiple sites (eg, hip, wrist, or spine) .…”