Slew of New Studies Spot Links Between Psychiatric Medications and Bone Loss, Fractures

Rob Wipond
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Four different studies conducted in different ways examining different groups have linked use of certain psychiatric drugs, particularly SSRI antidepressants and antipsychotics but also benzodiazepines, to bone fracture risks and negative impacts on human bone development.

One study in children and youth published in the Journal of Clinical Psychiatry found that taking antidepressants or the antipsychotic risperidone were associated with reduced bone mass. The University of Iowa-led team examined 94 boys aged 7 to 17 treated with risperidone for 6 months or more and compared their bone mass development relative to their respective ongoing use or discontinuation of risperidone or SSRI antidepressants. They found that the use of the psychiatric drugs was linked to bone growth impairment.

“Chronic SSRI treatment in children and adolescents is associated with reduced, albeit stable, bone mass for age, while chronic risperidone treatment is associated with failure to accrue bone mass,” the researchers concluded.

Publishing in Injury Prevention, a Northeastern University in Boston-led team examined data from the US PharMetrics Claims Database. “The study included more than 137,000 women ages 40 to 64 with no mental health issues who started SSRIs between 1998 and 2010,” reported MedPage Today. “The investigators compared this group with more than 236,000 women of the same age prescribed H2 antagonists or proton pump inhibitors (PPIs), typically used to treat indigestion, over the same time frame.” In the study, the researchers stated that, “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 fracture risk.” An independent commentator told MedPage Today that the 76% percent increase in fractures after one year of SSRI use needed to be considered against the relatively low risk of fractures in that age group.

Meanwhile, a study led by University of Tokyo researchers published in PLoS One examined records for 140,494 patients of which 830 suffered from in-hospital fractures. They determined that, “Short-acting benzodiazepine hypnotics and ultrashort-acting non-benzodiazepine hypnotics may increase risk of bone fracture in hospitalized dementia patients.”

And another study in the Journal of Clinical Psychiatry involved patients diagnosed with schizophrenia. Taiwanese researchers examined records of 605 cases of hip fracture and 2,828 matched controls over ten years from the National Health Insurance Research Database in Taiwan. They found that antipsychotic use was linked to a 61% increase in risk of hip fracture and concluded that, “These results extend previous findings and demonstrate an increased risk of hip fracture associated with antipsychotic use in schizophrenia subjects.”

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Calarge, Chadi A., Trudy L. Burns, Janet A. Schlechte, and Babette S. Zemel. “Longitudinal Examination of the Skeletal Effects of Selective Serotonin Reuptake Inhibitors and Risperidone in Boys.” The Journal of Clinical Psychiatry, May 27, 2015, 607–13. doi:10.4088/JCP.14m09195. (Abstract)

Tamiya, Hiroyuki, Hideo Yasunaga, Hiroki Matusi, Kiyohide Fushimi, Sumito Ogawa, and Masahiro Akishita. “Hypnotics and the Occurrence of Bone Fractures in Hospitalized Dementia Patients: A Matched Case-Control Study Using a National Inpatient Database.” PLoS ONE 10, no. 6 (June 10, 2015): e0129366. doi:10.1371/journal.pone.0129366. (Full text)

Sheu, Yi-han, Amy Lanteigne, Til Stürmer, Virginia Pate, Deborah Azrael, and Matthew Miller. “SSRI Use and Risk of Fractures among Perimenopausal Women without Mental Disorders.” Injury Prevention, June 25, 2015, injuryprev – 2014–041483. doi:10.1136/injuryprev-2014-041483. (Full text)

Antidepressants Linked to Bone Fractures in Menopausal Women (MedPage Today, June 25, 2015)

Wu, Chi-Shin, Chia-Ming Chang, Yu-Ting Tsai, Ya-Wen Huang, and Hui-Ju Tsai. “Antipsychotic Treatment and the Risk of Hip Fracture in Subjects With Schizophrenia: A 10-Year Population-Based Case-Control Study.” The Journal of Clinical Psychiatry, June 23, 2015. doi:10.4088/JCP.14m09098. (Abstract)

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Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.

7 COMMENTS

  1. Dear Rob
    From a practising psychiatrist, THANK YOU from the bottom of my heart for scanning the literature and highlighting key / relevant studies regarding what should be every prescribers’ FIRST duty – to be very aware of the potential/actual harms of the poisons we have the responsibility of prescribing, which are sometimes useful and called “medications”.
    With deep gratitude, rob purssey

  2. Obvious if you think of the effects of strong psychiatric drugs designed to make the person immobile.
    If the person is not moving, it is well know muscles and bones atrophy from lack of use.
    The most extreme example is an astronaut that comes back from orbiting the earth. They lose bone and muscle from lack of constant exercise.

  3. According to my medical records, I was given my first antipsychotic, Risperdal, because of a “bad fix” on a broken bone. Sure does seem the psychiatric practitioners I dealt with did everything 100% wrong. “When first we practice to deceive, oh what a tangled web we weave.”

  4. While on Zyprex and SSRIs I noticed a significant deterioration in my balance and coordination and had several falls. I have always been fit, athletic, and well balanced and coordinated. Now after a few years off them and some hard work at the gym and a concentrated effort, my balance etc is gradually improving again…thank goodness. Maybe I will ski again.

    The impact of these rotten drugs on coordination and balance needs urgent attention as they are often forced on elderly people more likely to suffer falls and fractures. I guess it is one way psychiatry can “refer” patients (read victims) to surgeons etc.

    Of course, it’s more likely they’ll could the principle that, “if they are able to move, they may fall over, so to prevent them falling over we need to immobilise them completely with higher doses….it’s for their own good, don’t you know – medically indicated!!!”

    When will these drugs be banned?

  5. This is absolutely disastrous if it’s true. Given the number of kids on these drugs we’re creating a massive health problem for the next 100yrs. The bone mass they won’t get as kids is unlikely to be completely recovered later and then when they age… disaster.