SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2012
Selective serotonin reuptake inhibitor treatment and risk of fractures: a meta-analysis of cohort and case-control studies.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 7 syntheses or guidelines pooled it, 150 citations in OpenAlex.
- Alliance between selective serotonin reuptake inhibitors and fracture risk: an updated systematic review and meta-analysis.European journal of clinical pharmacology · 2020Pooled it
- Lithium use and risk of fracture: a systematic review and meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- The effect of selective serotonin re-uptake inhibitors on risk of type II diabetes mellitus and acute pancreatitis: a meta-analysis.Bioscience reports · 2018Pooled it
- Effect of selective serotonin reuptake inhibitors on bone mineral density: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Pooled it
- Zolpidem use and risk of fractures: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Pooled it
- Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Pooled it
- Depression, antidepressants, and bone health in older adults: a systematic review.Journal of the American Geriatrics Society · 2014Pooled it
- Effects of escitalopram on markers of bone turnover: a randomized clinical trial.The Journal of clinical endocrinology and metabolism · 2014Trial
- Do premenopausal women with major depression have low bone mineral density? A 36-month prospective study.PloS one · 2012Trial
- Review
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- Medication-Related Impacts on Pediatric Bone Health.Journal of the Pediatric Orthopaedic Society of North America · 2025Review
- Post-stroke Bone Fragility: Early Bone Loss, Risk Factors, and Recovery Considerations.Cureus · 2025Review
- Do Systemic Diseases and Medications Influence Dental Implant Osseointegration and Dental Implant Health? An Umbrella Review.Dentistry journal · 2023Review
- Reply to comments on "Effect of selective serotonin reuptake inhibitors on bone mineral density: a systematic review and meta-analysis".Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Fluoxetine improves bone microarchitecture and mechanical properties in rodents undergoing chronic mild stress - an animal model of depression.Translational psychiatry · 2022Article
- Skeletal Aging.Mayo Clinic proceedings · 2022Review
- Antidepressants and Vertebral and Hip Risk Fracture: An Updated Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2022Review
- Prospective association between depressive symptoms and hip fracture and fall among middle-aged and older Chinese individuals.BMC psychiatry · 2022Article
- Molecular actions of sex hormones in the brain and their potential treatment use in anxiety disorders.Frontiers in psychiatry · 2022Review
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledStudies on use of selective serotonin reuptake inhibitors (SSRIs) and risk of fracture have yielded inconsistent results. This meta-analysis, which pooled results from 13 qualifying cohort and case-control studies, found that SSRIs were associated with a significantly increased risk of fractures.
introductionThis study was conducted to assess whether people who take SSRIs are at an increased risk of fracture.
methodsWe conducted a meta-analysis of observational studies. Relevant studies published by February 2010 were identified through literature searches using MEDLINE (from 1966), EMBASE (from 1988), PsycINFO (from 1806), and manual searching of reference lists. Only cohort or case-control studies that examined the association of SSRIs and risk of fracture and bone loss were included. Data were abstracted independently by two investigators using a standardized protocol; disagreements were resolved by consensus. Random effects models were used for pooled analysis due to heterogeneity in the studies.
resultsThirteen studies met inclusion criteria. Overall, SSRI use was associated with a significantly increased risk of fracture (relative risk, RR, 1.72; 95% CI [1.51, 1.95]; P < 0.001). An increased fracture risk associated with SSRIs also was observed in the three studies that adjusted for bone mineral density (RR, 1.70; 95% CI [1.28, 2.25]; P < 0.001) and in the four studies that adjusted for depression (RR 1.74; 95% CI [1.28, 2.36]; P < 0.001). SSRI use was not associated with bone loss in the two cohort studies of women (P = 0.29). The overall association between SSRI use and fracture risk was weaker (RR, 1.40; 95% CI [1.22, 1.61]), though still significant (P < 0.001) in analyses that accounted for apparent publication bias.
conclusionsUse of SSRIs is associated with increased risk of fracture. The SSRIs may exert an increased risk of fracture independent of depression and bone mineral density.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.