Do Antidepressants Make Bones Brittle?

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Other research has also uncovered a link between depression itself and an increased risk of fractures.

Goltzman said he and his colleagues are now looking at teens who take SSRIs, to see if there are any effects from the drugs on growing bones. The researchers want to determine if there's a genetic predilection for osteoporosis, the brittle bone disease that can lead to fractures, that's induced by the antidepressants.

While the studies suggest an association between antidepressant use and fractures, no research has found a cause-and-effect relationship, Spangler said.

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Charlie McAtee, a spokesperson for Eli Lilly and Company, which makes the popular SSRI Prozac (fluoxetine), agreed with Spangler that "the current data does not allow a definitive conclusion that fluoxetine contributes significantly to the risk of osteoporosis and fractures in fluoxetine-treated patients."

The link has been seen before, McAtee said. "The Prozac label does list osteoporosis as an event observed in clinical trials," he said. "This is listed as a rare (less than 1 in 10,000) occurrence."

Until more is known, Goltzman offered this advice: "I would advise individuals on SSRIs not to stop their medication if they are receiving the drugs for valid reasons. They should, however, strongly consider seeing their physician to be evaluated for osteoporosis, including having a bone density test done."

To help reduce the possibility of bone loss, whether you take antidepressants or not, bone health experts at the Mayo Clinic offer the following suggestions:

• Get enough calcium. All men and women older than age 65 should try to get 1,500 milligrams of elemental calcium a day.
• Get enough vitamin D. Men and women should get at least 800 international units (IU) daily.
• Exercise. You should couple strength-building with weight-bearing exercises, such as walking, stair climbing and skipping rope.
• Be sure to get soy in your diet. The plant estrogens in soy help maintain bone density and may reduce the risk of fractures.
• Don't smoke -- it leads to bone loss.
• Don't drink alcohol to excess. More than two drinks a day may reduce bone formation and limit the body's ability to absorb calcium.

More information

To learn more about osteoporosis, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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