Osteoporosis and Fracture Risk Associated with Novel Antidepressants: A Systematic Review and Meta-Analysis

Authors

  • Jin Hu Department of Orthopedics, Third Affiliated Hospital of Shanghai University/Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People’s Hospital, 325000 Wenzhou, Zhejiang, China
  • Kailuo Xie Department of Orthopedics, Third Affiliated Hospital of Shanghai University/Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People’s Hospital, 325000 Wenzhou, Zhejiang, China
  • Senxiang Wu Department of Neurology, Third Affiliated Hospital of Shanghai University/Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People’s Hospital, 325000 Wenzhou, Zhejiang, China
  • Yiyi Chen Department of Neurology, Third Affiliated Hospital of Shanghai University/Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People’s Hospital, 325000 Wenzhou, Zhejiang, China

DOI:

https://doi.org/10.62641/aep.v52i3.1560

Keywords:

novel antidepressants, osteoporosis, fracture, systematic review, meta-analysis

Abstract

Background: The use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), has been linked to adverse effects on bone health, but findings are conflicting. This study aimed to quantify the associations between newer antidepressants and bone mineral density (BMD) and fracture risk through a comprehensive meta-analysis.

Methods: Observational studies on the association between the use of novel antidepressants and BMD and hip fracture were systematically searched in PubMed, Embase, CINAHL, Cochrane Library, and Scopus. Random effects meta-analyses were conducted to pool results across the eligible studies. The heterogeneity, publication bias, and influence were assessed extensively.

Results: 14 eligible studies with 1,417,134 participants were identified. Antidepressant use was associated with significantly lower BMD compared to non-use at all skeletal sites examined, with pooled standardized mean differences (SMD) ranging from –0.02 (total hip) to –0.04 (femoral neck). Importantly, antidepressant use was associated with a 2.5-fold increased risk of hip fracture (pooled odds ratio (OR) 2.50, 95% CI 2.26–2.76). While heterogeneity was detected, the overall findings were robust in sensitivity analyses.

Conclusions: This meta-analysis provided strong evidence that novel antidepressants, especially widely used SSRIs, have detrimental impacts on bone health. The observed associations with decreased BMD and doubled hip fracture risk have important clinical implications.

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Published

2024-06-05

How to Cite

Hu, Jin, et al. “Osteoporosis and Fracture Risk Associated With Novel Antidepressants: A Systematic Review and Meta-Analysis”. Actas Españolas De Psiquiatría, vol. 52, no. 3, June 2024, pp. 334-46, doi:10.62641/aep.v52i3.1560.

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Section

Systematic Review