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Mood
Drugs Linked to Fractures in Elderly By
Adam Marcus HealthScoutNews
Reporter April
28, 2003 Elderly
women who take antidepressants and other drugs that affect the nervous
system may be prone to broken bones, a new study has found. The
study by U.S. researchers found that women taking mood medication were 70
percent more likely than those not on the drugs to suffer a broken hip. A
smaller but significant increase in the risk of fracture accompanied
taking other psychoactive drugs, like those to control seizures, and
narcotics. The
reason for the connection isn't clear. Some evidence has suggested that
people with depression tend to have weaker bones than others. Narcotic
drugs and sedatives may make people unsteady on their feet and thus more
prone to falling, although the link persisted even after accounting for
these factors, the researchers say. "When
patients are on these medications, [doctors] should be aware that they are
associated with an increased risk of fractures," says Dr. Mary
Whooley, an assistant professor of medicine at the University of
California, San Francisco, and a co-author of the study. They should take
steps to prevent falls -- recommending walkers and canes, if necessary --
and encourage habits that promote healthy bones, like quitting smoking and
getting regular exercise. A
report on the findings appears in the April 28 issue of the Archives of
Internal Medicine (news
- web
sites). Previous
research has tied antidepressant use and fractures. One study, from the
late 1990s, showed that women taking older, tricyclic mood drugs were more
likely to break bones than those on newer medications called selective
serotonin-reuptake inhibitors (SSRIs) like Prozac and Zoloft. The chances
of suffering a fracture rose with the dose of medication, but never got
much above twice the risk for women not on the drugs. The
latest study included more than 8,200 women age 65 and older and not
living in nursing homes. Of those, 8 percent were taking tranquilizers, 6
percent were on antidepressants, 5 percent were taking narcotics -- like
hydrocodone and oxycodone -- and 2 percent were using drugs to control
seizures. Over
the course of the study, 1,256 women, or 15 percent of the total, suffered
at least one broken bone away from the spine. Of those, 288 had a first
broken hip. The
researchers were able to take into account many factors known to affect
the risk of fractures, including smoking status, physical activity, and
the use of estrogen. Even after considering these, however, they still saw
a link between some of the drugs and broken bones. Tranquilizers
didn't seem to be associated with fractures, but mood drugs, narcotics and
possibly seizure medications were, the researchers say. As with the
earlier study, the latest work found no difference in fracture risk for
women taking either older or newer antidepressants. Dr.
Kristine Ensrud, an osteoporosis expert at the University of Minnesota and
lead author of the study, says the work highlights the need to keep better
track of patient care. "With
older patients, a lot of times they're getting care from multiple places.
Time needs to be spent to review the list of medications they're on, and
doctors need to know they're taking the right things," says Ensrud,
also of the Minneapolis VA Medical Center. More
than 320,000 Americans are hospitalized each year with broken hips. Nine
in 10 of these occur in people over the age of 65. Copyright
© 2002 Global Action on Aging
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