Evidence map›Paper›PMID 40757575›Full record

ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2025

The risk of fracture among women starting selective serotonin reuptake inhibitors.

Daniel H Solomon, Kristine M Ruppert, Yinjuan Lian, Genevieve Neal-Perry, Jane A Cauley, Sherri-Ann M Burnett-Bowie

Abstract read
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In one paragraph

Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Daniel H SolomonDepartment of Rheumatology, Brigham and Women's Hospital, Boston, MA 02115, USA.ORCID 0000-0001-8202-5428
Kristine M RuppertDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Yinjuan LianDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Genevieve Neal-PerryDepartment of Obstetrics-Gynecology, University of North Carolina, Chapel Hill, NC 27617,  USA.
Jane A CauleyDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Sherri-Ann M Burnett-BowieDepartment of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.ORCID 0000-0002-0064-096X

Funding

The Study of Women's Health Across the Nation (SWAN): The Impact of Midlife and the Menopause Transition on Health and Functioning in Early Old AgeU19AG063720 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SHERRI-ANN M BURNETT-BOWIE · 2020 to 2026
$61.3M
WOMENS HEALTH ACROSS THE NATION--COORDINATING CENTERU01AG012553 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BROOKS, MARIA MORI · 1994 to 2019
$37.7M
WOMENS HEALTH ACROSS THE NATION--ENDOCRINE LABU01AG012495 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MCCONNELL, DANIEL S · 1994 to 2018
$18.8M
WOMENS HEALTH ACROSS THE NATION--PITTSBURGHU01AG012546 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MATTHEWS, KAREN · 1994 to 2019
$16.2M
WOMENS HEALTH ACROSS THE NATION--UCDAVISU01AG012554 · NIA · UNIVERSITY OF CALIFORNIA DAVIS · PI GOLD, ELLEN B. · 1994 to 2019
$14.5M
WOMENS HEALTH ACROSS THE NATION--UCLAU01AG012539 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI GREENDALE, GAIL A · 1994 to 2018
$13.7M
THE STUDY OF WOMEN'S HEALTH ACROSS THE NATION-MICHIGANU01NR004061 · NINR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HARLOW, SIOBAN D · 1994 to 2018
$12.9M
WOMENS HEALTH ACROSS THE NATION--CHICAGOU01AG012505 · NIA · RUSH UNIVERSITY MEDICAL CENTER · PI KRAVITZ, HOWARD M · 1994 to 2019
$11.9M
WOMENS HEALTH ACROSS THE NATION--MASSACHUSETTS GENERAL HU01AG012531 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI FINKELSTEIN, JOEL S · 1994 to 2019
$10.7M
Women's Health Across the Nation-New Jersey SiteU01AG012535 · NIA · UNIV OF MED/DENT OF NJ-NJ MEDICAL SCHOOL · PI DERBY, CAROL A. · 1994 to 2019
$9.2M
SWAN Sleep Study II: PittsburghR01AG019362 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HALL, MARTICA HELON · 2002 to 2008
$3.5M
NIA NIH HHS R01 AG019362NIH HHSNIH Office of Research on Women's Health U01AG012495NIH Office of Research on Women's Health U01AG012505NIH Office of Research on Women's Health U01AG012531NIH Office of Research on Women's Health U01AG012535NIH Office of Research on Women's Health U01AG012539NIH Office of Research on Women's Health U01AG012546NIH Office of Research on Women's Health U01AG012553NIH Office of Research on Women's Health U01AG012554NIH Office of Research on Women's Health U01NR004061NIH Office of Research on Women's Health U19AG063720NINR NIH HHSStudy of Women's Health Across the Nation
6 · The paper itself

Abstract

Increased fracture risk has been reported in patients using selective serotonin reuptake inhibitors (SSRIs). However, prior studies have had limited information regarding BMD and symptoms of depression, both potentially important confounders. We examined a longitudinal cohort of women who initiated SSRIs, other antidepressant (AD) medications, or no AD to estimate the risk of fracture associated with start of SSRIs. The Study of Women's Health Across the Nation (SWAN) is a longitudinal cohort of diverse women from across the US transitioning across the menopause. Study visits are approximately yearly, with reporting of medication use, fracture incidence (any and non-traumatic), mental health scales (CES-D), and BMD (the latter occurring in selected SWAN sites). We estimated fracture incidence and relative risk among women starting SSRIs or other AD, and compared them with women not starting SSRIs or other AD. Multivariable Cox regression models with increasing adjustment were constructed. As well, secondary analyses focused on non-traumatic fractures and women with BMD measurements. The Study of Women's Health Across the Nation includes 3302 total women, of which 286 were excluded because of prevalent AD use and 1167 because they did not have adequate follow-up time, had a fracture prior to start of an AD, or could not be matched; this left 1849 women for analysis. The incidence rates for any fracture (per 100 person-years) for SSRI users was 2.64 (95% CI: 1.82-3.71), other AD users 0.80 (95% CI: 0.22-2.04), and non-users 1.21 (95% CI: 1.07-1.36). Fully adjusted regression models found an increased hazard ratio for any fracture among women starting SSRIs compared with no AD (HR 1.77, 95% CI: 1.15-2.74). These results were consistent for non-traumatic fractures and in subgroups with BMD included as a covariate. Initiation of SSRI among women in mid-life was associated with an increased risk of fracture.

Indexed as

Fractures, BoneSelective Serotonin Reuptake InhibitorsAdultAgedBone DensityFemaleHumansIncidenceLongitudinal StudiesMiddle AgedRisk FactorsUnited StatesSelective Serotonin Reuptake Inhibitorsantidepressantsfracturesmidlifeosteoporosisselective serotonin reuptake inhibitors

Identifiers

PMID40757575
PMCPMC12578294

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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.