Osteoporosis International

, Volume 17, Issue 6, pp 807–816

Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture

Original Article

DOI: 10.1007/s00198-005-0065-y

Cite this article as:
Vestergaard, P., Rejnmark, L. & Mosekilde, L. Osteoporos Int (2006) 17: 807. doi:10.1007/s00198-005-0065-y

Abstract

Introduction: Our objective was to study the association between fracture risk and the use of anxiolytics and sedatives (benzodiazepines, etc.), neuroleptics and antidepressants. Subjects and methods: This was a case control study. All cases consisted of subjects who had sustained a fracture during the year 2000 (n=124,655). For each case, three controls (n=373,962) matched for age and gender were randomly drawn from the background population. Exposure was defined as the use of neuroleptics, antidepressants and anxiolytics/sedatives, psychiatric disease (manic depressive states, schizophrenia, other psychoses), and other confounders. The effect of dose was examined as a defined daily dose per day (DDD/day). The values referred to are confounder-adjusted. Results: For anxiolytics and sedatives, there was a small increase in overall fracture risk (OR: around 1.1) even with limited doses (<0.1 DDD/day). No dose-response relationship was observed for anxiolytics and sedatives. For neuroleptics, a limited increase in overall fracture risk was observed (OR: around 1.2 from <0.05 DDD/day with no dose-response relationship). For antidepressants, a dose-response relationship was observed for fracture risk (OR: increasing from 1.15, 95% CI: 1.11–1.19 at <0.15 DDD/day to 1.40, 95% CI: 1.35–1.46 for ≥0.75 DDD/day). The risk of fracture was higher with selective serotonin re-uptake inhibitors than with tricyclic antidepressants. Conclusions: Small increases in fracture risk were seen with the use of anxiolytics and sedatives and neuroleptics without a dose-response relationship. The increase may be linked to an increased risk of falls. For antidepressants, a dose-response relationship was found, with a higher fracture risk for selective serotonin re-uptake inhibitors.

Keywords

Antidepressants Anxiolytics Fracture Neuroleptics Osteoporosis Sedatives 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Authors and Affiliations

  1. 1.Department of Endocrinology and Metabolism CAarhus University Hospital, Aarhus SygehusAarhus  CDenmark
  2. 2.The Osteoporosis ClinicAarhus AmtssygehusAarhus CDenmark