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GPs urged to limit SSRIs for menopausal symptoms over fracture concern

GPs should only prescribe SSRIs for as short a time as possible in women taking the drugs for menopausal symptoms, according to researchers who found their use may increase the risk of bone fractures.

The team found fractures were 76% more common after one year in women prescribed SSRIs to control menopausal symptoms than in women of the same age who were not taking the drugs. The higher fracture risk also persisted over five years of treatment.

Although their study was only observational and therefore unable to show whether SSRI use was actually causing the increase in bone fractures, the authors said antidepressants are thought to promote bone thinning at a molecular level.

They concluded: ‘SSRIs appear to increase fracture risk among middle aged women without psychiatric disorders, an effect sustained over time, suggesting that shorter duration of treatment may decrease [this].’

Inj Prev 2015; available on line 25 June

Readers' comments (6)

  • Vinci Ho

    I presume the author wants to generalise to include SNRIs as well??
    Weaknesses in observational studies are well known.....

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  • Are they suggesting that middle aged women with psychiatric disorders don't experience this effect? Are they suggesting presence of a psychiatric disorder is protective?

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  • Another day another horseshit trial

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  • And how many patients is this affecting, oh please.

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  • Just because they did not code depression and treated as vasomotor menopause symptoms - did this mean they screened negative for mh symptoms . Does anxiety / depression mean the patents prefer this or are steered to this instead of hrt ? V . Large no of cases to controls

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  • This debate of course assumes that these drugs work in the first place. There is no solid evidence that serotonin levels are related to depression in the first place. Also the best available met-analysis of trials on ssri drugs basically says they are no better than placebo. Its great that there is a new scare story at last about these drugs. They take up so much of primary care time but unfortunately the myth that these drugs actually work is now part of the DNA of the average doctor - until the next wonder mood altering drug comes along of course.
    How on earth have these drugs got a licence for so many unrelated complaint - duloxetine - neuropathy depression and stress incontinence. Big pharma must think we are stupid.

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