For millions of Canadians, daily doses of antidepressants are essential for maintaining a healthy mental and emotional state. Although antidepressants may benefit the mind, new research raises questions about their effect on the body.
Dr. David Goltzman, a researcher from McGill University and supported by the Canadian Institutes of Health Research, looked at bone health in people over the age of 50 who were taking a popular form of anti-depressants called selective serotonin reuptake inhibitors (SSRIs). Goltzman leads a team of researchers at the Canadian Multicentre Osteoporosis Study (CaMos).
SSRIs help keep depression at bay by increasing the impact of a chemical called serotonin; an important mood regulator.
More than 5,000 people taking SSRIs had their bones tested using x-rays and a special machine called a bone densitometer as part of a five-year study by Goltzman's team, once at the beginning of the study and a second time five years later.
The research team found that people over the age of 50 who took SSRIs daily were twice as likely to have weaker hip bones and vertebra. These factors increase the risk of breaking bones.
"In our view, SSRIs are good medications for depressed patients. When they are correctly prescribed, they work well and they shouldn't be stopped," Goltzman says. "All medication will have side effects and this is an important side effect but it's not something we think should stop people from using it."
However, Goltzman also notes that therapies using SSRIs for treating depression, especially among the elderly, may need to include strategies for preventing osteoporosis.
"We think patients should have a bone mineral density test both at the start and at regular intervals after SSRI's are given to see if they have low bone density," Goltzman says. "If bone mineral density is worsening on the SSRIs, then they should have life style measures introduced to prevent osteoporosis."
This means ensuring that people on SSRIs get enough calcium and vitamin D in their diet, exercise regularly, stop using tobacco and drink moderately. It's good advice for people on SSRIs and for those of us who just want to maintain good bone health now and in the future.
