Tuesday, November 27, 2007

No free rides

And antidepressants are no exception. The class of antidepressants known as SSRIs-- Prozac, Zoloft, Paxil, and others--have absolutely revolutionized the treatment of depression and anxiety in the last 20 years. Research published this year in the Archives of Internal Medicine, however, suggests that which is good for the brain is bad to the bone.

Canadian researchers studied a group of 5,000 some adults over 50, following their health outcomes over 5 years for incidence of falls and fractures. In particular, they were checking for 'fragility fractures' or those broken bones resulting from minimal trauma such as falling out of bed.

Those subjects who were under treatment with SSRIs were 1.5 times more likely to pitch over in a fall and 2 times more likely to break a bone--not necessarily related to those increased falls--than their colleagues who were toughing out the modern world without the support of medications.

This adds another tough decision in our 'better living through chemistry' kind of lives. SSRIs can literally be life-saving, and their benefits most definitely enhance life's journey for many. As the authors note: "These risks must be balanced against the benefits gained by the treatment of depression with SSRIs."


KGMom said...

I really enjoy your posts on these various medical issues.
I am particularly sensitized to information on depression. My father had several episodes of acute depression about 20 years ago. Meds did not help him, and eventually he was successfully treated with electric shock treatments.

Mauigirl said...

KGMom, my dad had the same experience. Shock treatments really helped him. He also found some help in medications after that.

I'm on Prozac myself and do not want to go off it as I find I am much more emotionally stable on it than when I'm not. I guess I should take special care to take calcium supplements and exercise to counteract the effects.

denverdoc said...

KGM, I'm glad that ECT was helpful to your dad. I have to note again that a story he wrote about driving a car at 17 that you've posted on your blog is one of the most perfectly crafted pieces of writing I've ever read.

MG, I just found out today that Prozac and other SSRIs are associated with increased incidence of bleeding gastric ulcers when used along with NSAIDs. Seems you can't get away with boosting any one body function without having a possible adverse effect on some other part. This patient I saw today was thrilled with the benefits of just a small dose of Paxil. Unfortunately, she now has recurrent stomach pain just like she had with a prior gastric ulcer... and that occurred during the last time she tried Paxil! Sure enough, on checking I found ample evidence that the two are connected.