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Depression, Anxiety, SSRIs, and Bone Metabolism

J Bone Miner Res; ePub 2017 Sep 22; Calarge, et al

In older adolescents and emerging adults, major depressive disorder (MDD) and generalized anxiety disorder (GAD) are associated with increasing bone mass, particularly in the lumbar spine and in females, whereas selective serotonin reuptake inhibitors (SSRIs) are associated with increasing bone mass in females but decreasing bone mass in males, according to a recent study. Medically healthy 15- to 20-year-olds (n=264), who were unmedicated or within 1 month of starting an SSRI, were prospectively followed. Psychiatric functioning and medication treatment were assessed monthly. Every 4 months, trabecular and cortical volumetric bone mineral density (vBMD) at the radius and markers of bone metabolism were evaluated. Every 8 months, total body less head areal bone mineral content and lumbar spine (LS) areal BMD (aBMD) were determined. Researchers found:

  • After adjusting for age, sex, vitamin D concentration, physical activity, lean mass or grip strength, and time in the study, MDD severity was associated with increasing LS aBMD.
  • Similarly, SSRI use was associated with increasing LS aBMD and bone formation in female participants.
  • In contrast, SSRI use was associated with decreasing LS aBMD in males.
Citation:

Calarge CA, Mills JA, Janz KF, et al. The effect of depression, generalized anxiety, and selective serotonin reuptake inhibitors on change in bone metabolism in adolescents and emerging adults. [Published online ahead of print September 22, 2017]. J Bone Miner Res. doi:10.1002/jbmr.3238.

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