A previously identified link between antidepressant use and hip fractures needs further examination, the authors of a study published in JAMA Psychiatry (2 January 2019) have concluded
Researchers analysed data on 204,072 people in Sweden aged 65 years and over (mean 80.1 years) who initiated antidepressant treatment between July 2006 and December 2011, matched by age and gender to an equal number of controls.
In comparison with controls, antidepressant users were more than twice as likely to experience hip fracture in both the year before (1.1% vs. 2.8%) and the year after (1.3% vs. 3.5%) therapy initiation. The risk was most elevated in the period 16–30 days before the first prescription was filled, both overall and in all subgroup analyses.
Previous research has associated antidepressant use with an increased risk of falls and fractures. However, there have been no sufficiently powered randomised trials to establish causation, the researchers explained.
They said their findings suggested that older people with depression already have an elevated risk of falls and fractures prior to antidepressant initiation, due to a high burden of comorbidity and confounding by indication.
“These findings raise questions about the association between antidepressant drug use and hip fracture that require further analysis in treatment studies.”