Calcaneal Bone Mineral Density in Young Adults Prescribed Selective Serotonin Reuptake Inhibitors

Background: Several previous studies have reported both an association between selective serotonin reuptake inhibitors (SSRI) and decreased bone mineral density and increased fractures, but no previous studies have specifically evaluated bone health in young adults who have a history of SSRI use. Objective: The purpose was to characterize the effect SSRI use in early adulthood on bone mineral density. Methods: A cross-sectional study was conducted on subjects who voluntarily responded to recruitment methods for the study. Young adults aged 18 to 25 years who were currently or had previously taken an SSRI for a minimum of 3 consecutive months were included in the study. A subject interview was conducted on each patient to collect background information. Each subject's calcaneal bone mineral density was then measured with an ultras onometer. Results: Complete data were collected on 51 subjects. The median duration of SSRI use was 24 54 months. A significant negative correlation was observed between SSRI duration and calcaneal ultrasound T-score (r=-0.53, P<0.001) which was unchanged in depressed subjects. Subjects on continuous SSRIs for >24 months had a significantly lower median T-score (0.30 +/- 0.93) than subjects taking SSRIs for <= 24 months (0.90 +/- 0.81; P=0.0010). Conclusions: In this young relatively healthy population who were following most of the recommendations to improve bone health, a significant negative correlation was observed between the duration of SSRI use and bone mineral density. Subjects who were on SSRIs for longer than 24 months had a significantly lower T-score. Further large scale longitudinal studies are needed in this younger population to determine the effects of chronic SSRI use on bone health. (Clin Ther. 2013;35:1412-1417) (C) 2013 Elsevier HS Journals, Inc. All rights reserved.