Link Between Antidepressants and Hip Fractures Called into Question

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

A new study, published in JAMA Psychiatry, casts some doubt on the association between antidepressant use and hip fracture in older adults.

Using a Swedish prescription drug database, researchers matched 200,000 adults aged 65 and older who started antidepressants between 2006 and 2011 with 200,000 who didn't receive antidepressants. During the year before and after starting treatment, elders who used antidepressants had nearly three times the number of hip fractures as controls (roughly 12,800 vs. 4,800). However, the risk increase was similar in the year before and after treatment — and actually peaked in the 16–30 days before treatment initiation (odds ratio, 5.8).

The researchers say their results "raise questions about associations between antidepressant use and hip fracture seen in previous observational studies." Editorialists, meanwhile, are more cautious: "We suggest that clinicians would still be wise to inform patients about the potential risk of falling and fractures that may follow antidepressant use. ... However, for most older adults, the toll of untreated depression will likely outweigh the potential risks associated with antidepressant use."