Depression-osteoporosis link still unclear

Older women who take certain antidepressants are at increased risk of fracturing a bone, but it's not clear whether the association is due to the drugs, depression itself, or some other factor, according to a new report in the Harvard Women's Health Watch.

Nevertheless, while women shouldn't stop taking antidepressant drugs for the sole reason of protecting their bones, those who suffer from depression should get their bone mineral density (BMD) checked out, the report's authors state.

They cite a study published this January in the Archives of Internal Medicine that found women over 50 who were taking selective serotonin reuptake inhibitors (SSRIs), a class of antidepressant drugs that includes Prozac and Zoloft, were twice as likely to suffer fractures compared with their peers who weren't taking SSRIs.

However, the researchers add, just 137 of the more than 5,000 study participants were on SSRIs, and these women were also more likely to be taking other drugs that could contribute to bone loss.

Nevertheless, the Harvard newsletter article authors point out that there have been reports since the 1990s linking depression in women, even younger women in whom thinning bones is relatively rare, to lower bone mineral density (BMD). One of these studies found depressed women had higher levels of the stress hormone cortisol, which contributes to bone loss.

Another study in animals found depression boosted secretion of another hormone, noradrenalin, which blocks the activity of bone-forming cells. A number of other substances in the body, including leptin, may also be involved in the mental health-bone strength link, the authors state.

Depressed women simply may not eat as well and exercise as much as their non-depressed peers, both of which can lead to bone loss, the authors add.

Dr. Jessica Goren, a clinical psychiatric pharmacist at Cambridge Health Alliance, notes that depressed individuals should be informed and counseled on their osteoporosis risk, "because regardless of whether depression is an independent factor, lifestyle is."

The authors conclude that by urging women who are taking antidepressants not to quit out of fear of osteoporosis, but instead suggest they discuss their risk with their doctor and get a BMD test.

It's also key for women to take in enough calcium and vitamin D (1,000 mg-1,200 mg and 800 IU-1,000 IU), respectively, they add, and to exercise regularly -- which can improve mood as well as keep bones strong.

source : news.yahoo.com