Discussions that mention prozac

Osteoporosis board


There are many news items today about a new study showing that elderly users of SSRI antidepressants (Prozac, Zoloft, etc.) have:
Increased risk of falls
Twice the risk of bone fractures
Lower BMD (-4% hip, -2.4% spine).

But it's not clear to me that the lower BMD is really caused by the antidepressants, particularly since a study a few months back indicated that Prozac increased BMD in mice.

Since people who are not physically active are more likely to become depressed (and need antidepressants), might the lower BMD really be caused by their lower levels of physical activity, and not by the antidepressants? :confused:
[QUOTE=DesertBloom;2759410]...In this study though they mentioned that they took dizziness, and physical frailty into consideration, and thought that there was some other link to fractures, but then they don't say what that is.

I found another article, which gives a more thorough review of the study. It says that bone mineral density and falls may be affected adversely by daily SSRI use but that fracture rates remain elevated despite adjustment for these two risk factors. And, depressive symptoms were also unlikely to have been responsible for the link between fracture and SSRIs because the researchers found no association between symptoms and fractures in univariate or multivariate regression models (whatever that means).

So this is indeed troublesome for those of us with osteoporosis who take antidepressants. :eek: (I've been on Prozac for four years.)
[QUOTE=PikaB;2760012]
...So this is indeed troublesome for those of us with osteoporosis who take antidepressants. :eek: (I've been on Prozac for four years.)

PikaB: In those four years, has your bmd gone down? I was also wondering if you are still on forteo? Have you made that bandelero yet ;) ?

If you haven't lost any density and it's gone up (I hope) then I wouldn't think that the Prozac is doing anything detrimental, to your bones, unless the study is saying that this loss of bone occurs over a longer length of time, or has some cumalative affect. If I were you or anyone else taking SSRI, I would worry more about the affects of depression on bone than the med, until they present a better study; for some reason this one isn't making a whole lot of sense to me.

Did they say how this malabsorption of serotonin is adversely affecting the osteoblasts? Isn't there a whole list of other meds/medical conditions that could affect bone resorption if the link is it's affect on the reabsorption of serotonin?:dizzy:
[QUOTE=DesertBloom;2761506]PikaB: In those four years, has your bmd gone down? I was also wondering if you are still on forteo? Have you made that bandelero yet ;) ?
My osteoporosis developed during the time I was on Prozac, so it's reasonable to assume that it is probably a contributing factor. Spine BMD in Jan. 2004 was T=-2.2; in Jan. 2005 was T=-2.65.

I have been on Forteo for 10 months; during that time there has been slight BMD improvement (to T=-2.5) but not as much as I had hoped. It seems possible that the Prozac is reducing the beneficial effect of Forteo. Even worse, I really am troubled by the icky thought that while Forteo is building new bone, the Prozac may be promptly turning that new bone brittle. (In the study, fracture rate among SSRI users was much higher even when BMD was accounted for.) So my current (spur-of-the-moment) plan is to try to eliminate the use of Prozac during the next two months, so that during my second year of Forteo I can hopefully get its full benefit. If severe depression emerges, I'll cross that bridge when I come to it. Right now my bones have priority, since there is such a short window for Forteo use.

(And, I'm still saving my empty Forteo pens, but haven't done anything further toward the bandelero.)
PikaB,
I hope the Forteo does work for you and you can get along with the Prozac. Why are you saving the Forteo pens?