Grant: Rapid Funding for DSEN Targeted Research

Antidepressant drugs including selective serotonin reuptake inhibitors (SSRIs), trycyclic antidepressants (TCAs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) are frequently used in Canada and the United States to treat patients with depression. These treatments have been associated with notable increases in consumption in recent years, and are now also being prescribed for patients to help manage other conditions including anxiety, sleep disorders, migraine headache and fibromyalgia. Since the 1990s, there has been concern that patients' use of these treatments could possibly be associated with a weakening of their bone strength and an increased risk of suffering a significant bone fracture which may greatly impact quality of life. Fractures and falls represent a major source of costs, significant morbidity and mortality, particularly in the elderly population. While past clinical studies have tried to determine whether antidepressant drugs do have important effects on bone strength and the risk of fractures, there does not yet exist a clear answer to this question or to exactly how these drugs may effect bone. If such a relationship exists, it will be important for physicians who prescribe antidepressants to be aware of this information and to consider drug characteristics and patient histories in chosen treatments. The proposed research will use a systematic process to compile and analyze all relevant published evidence to explore if antidepressants increase the chance of important changes in bone strength and risk of fractures, and specifically whether a particular characteristic of these drugs called serotonin affinity plays an important role in a potential association. Findings from this work will be shared with key stakeholders to maximize awareness of the information that comes from this work.