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Effects of Depression and Serotonergic Antidepressants on Bone: Mechanisms and Implications for the Treatment of Depression

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Abstract

Osteoporosis is a chronic skeletal disease marked by microarchitectural deterioration of the bone matrix and depletion of bone mineral density (BMD), with a consequent increased risk for fragility fractures. It has been frequently associated with depression, which is also a chronic and debilitating disorder with high prevalence. Selective serotonin reuptake inhibitors (SSRIs), first-line agents in the pharmacological treatment of mood and anxiety disorders, have also been shown to negatively affect bone metabolism. SSRIs are the most prescribed antidepressants worldwide and a large number of persons at risk of developing osteoporosis, including older patients, will receive these antidepressants. Therefore, a proper musculoskeletal evaluation of individuals who are being targeted for or using SSRIs is a priority. The aim of this article is to review the evidence regarding the effects of depression and serotonergic antidepressants on bone and its implications for clinical care.

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Authors and Affiliations

  1. IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281, Geelong, VIC, 3220, Australia

    Brisa S. Fernandes, Julie A. Pasco, Michael Berk & Lana J. Williams

  2. Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Brisa S. Fernandes

  3. Barwon Biomedical Research, Barwon Health University Hospital, Geelong, VIC, Australia

    Jason M. Hodge

  4. MMR Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia

    Jason M. Hodge

  5. Department of Medicine, The University of Melbourne, St Albans, VIC, Australia

    Julie A. Pasco

  6. Florey Institute for Neuroscience and Mental Health, Department of Psychiatry and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia

    Michael Berk

Authors
  1. Brisa S. Fernandes
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  2. Jason M. Hodge
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  5. Lana J. Williams
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Corresponding author

Correspondence to Lana J. Williams.

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The study was supported by the National Health and Medical Research Council (NHMRC), Australia (projects 1026265, 1009367, 628582, 509103).

Brisa S. Fernandes is supported by a scholarship and by a research grant MCTI/CNPQ/Universal 14/2014 461833/2014-0, both from CNPq, Brazil. Michael Berk is supported by a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship (1059660). Lana J. Williams is supported by an NHMRC Career Development Fellowship (1064272).

Conflict of interest

Brisa S. Fernandes, Jason M. Hodge, Julie A. Pasco, Michael Berk, and Lana J. Williams have no conflicts of interest regarding this subject.

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Fernandes, B.S., Hodge, J.M., Pasco, J.A. et al. Effects of Depression and Serotonergic Antidepressants on Bone: Mechanisms and Implications for the Treatment of Depression. Drugs Aging 33, 21–25 (2016). https://doi.org/10.1007/s40266-015-0323-4

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  • DOI: https://doi.org/10.1007/s40266-015-0323-4

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