Effects of Depression and Serotonergic Antidepressants on Bone: Mechanisms and Implications for the Treatment of Depression
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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.
KeywordsOsteoporosis Serotonin Bone Mass Osteoporotic Fracture Fragility Fracture
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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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