UNLABELLED: Antidepressants are associated with bone loss and fractures in older adults. We treated depressed older adults with an antidepressant and examined its effects on bone turnover by comparing blood samples before and after treatment. Bone resorption increased after antidepressant treatment, which may increase fracture risk. INTRODUCTION: Antidepressants have been associated with increased bone loss and fractures in older adults in observational studies, but the mechanism is unclear. We examined the effects of a serotonin-norepinephrine reuptake inhibitor, venlafaxine, on biomarkers of bone turnover in a prospective treatment study of late-life depression. METHODS: Seventy-six individuals aged 60 years and older with current major depressive disorder received a 12-week course of venlafaxine XR 150-300 mg daily. We measured serum C-terminal cross-linking telopeptide of type I collagen (β-CTX) and N-terminal propeptide of type I procollagen (P1NP), measures of bone resorption and formation, respectively, before and after treatment. We then analyzed the change in β-CTX and P1NP within each participant. Venlafaxine levels were measured at the end of the study. We assessed depression severity at baseline and remission status after treatment. RESULTS: After 12 weeks of venlafaxine, β-CTX increased significantly, whereas P1NP did not significantly change. The increase in β-CTX was significant only in participants whose depression did not remit (increase by 10 % in non-remitters vs. 4 % in remitters). Change in β-CTX was not correlated with serum levels of venlafaxine or norvenlafaxine. CONCLUSION: Our findings suggest that the primary effect of serotonergic antidepressants is to increase bone resorption. However, such an increase in bone resorption seemed to depend on whether or not participants' depression remitted. Our results are in agreement with prior observational studies reporting increased bone loss in older adults taking serotonergic antidepressants. These negative effects on bone homeostasis could potentially contribute to increased fracture risk in older adults.
UNLABELLED: Antidepressants are associated with bone loss and fractures in older adults. We treated depressed older adults with an antidepressant and examined its effects on bone turnover by comparing blood samples before and after treatment. Bone resorption increased after antidepressant treatment, which may increase fracture risk. INTRODUCTION: Antidepressants have been associated with increased bone loss and fractures in older adults in observational studies, but the mechanism is unclear. We examined the effects of a serotonin-norepinephrine reuptake inhibitor, venlafaxine, on biomarkers of bone turnover in a prospective treatment study of late-life depression. METHODS: Seventy-six individuals aged 60 years and older with current major depressive disorder received a 12-week course of venlafaxine XR 150-300 mg daily. We measured serum C-terminal cross-linking telopeptide of type I collagen (β-CTX) and N-terminal propeptide of type I procollagen (P1NP), measures of bone resorption and formation, respectively, before and after treatment. We then analyzed the change in β-CTX and P1NP within each participant. Venlafaxine levels were measured at the end of the study. We assessed depression severity at baseline and remission status after treatment. RESULTS: After 12 weeks of venlafaxine, β-CTX increased significantly, whereas P1NP did not significantly change. The increase in β-CTX was significant only in participants whose depression did not remit (increase by 10 % in non-remitters vs. 4 % in remitters). Change in β-CTX was not correlated with serum levels of venlafaxine or norvenlafaxine. CONCLUSION: Our findings suggest that the primary effect of serotonergic antidepressants is to increase bone resorption. However, such an increase in bone resorption seemed to depend on whether or not participants' depression remitted. Our results are in agreement with prior observational studies reporting increased bone loss in older adults taking serotonergic antidepressants. These negative effects on bone homeostasis could potentially contribute to increased fracture risk in older adults.
Authors: Stuart J Warden; Alexander G Robling; Megan S Sanders; Michael M Bliziotes; Charles H Turner Journal: Endocrinology Date: 2004-11-11 Impact factor: 4.736
Authors: Felice N Jacka; Julie A Pasco; Margaret J Henry; Mark A Kotowicz; Seetal Dodd; Geoff C Nicholson; Michael Berk Journal: Menopause Date: 2005 Jan-Feb Impact factor: 2.953
Authors: Ellen M Whyte; James Basinski; Panthea Farhi; Mary Amanda Dew; Amy Begley; Benoit H Mulsant; Charles F Reynolds Journal: J Clin Psychiatry Date: 2004-12 Impact factor: 4.384
Authors: Raz Yirmiya; Inbal Goshen; Alon Bajayo; Tirzah Kreisel; Sharon Feldman; Joseph Tam; Victoria Trembovler; Valér Csernus; Esther Shohami; Itai Bab Journal: Proc Natl Acad Sci U S A Date: 2006-10-30 Impact factor: 11.205
Authors: Elizabeth M Haney; Benjamin K S Chan; Susan J Diem; Kristine E Ensrud; Jane A Cauley; Elizabeth Barrett-Connor; Eric Orwoll; M Michael Bliziotes Journal: Arch Intern Med Date: 2007-06-25
Authors: N M Simon; K McNamara; C W Chow; R S Maser; G I Papakostas; M H Pollack; A A Nierenberg; M Fava; K K Wong Journal: Eur Neuropsychopharmacol Date: 2007-08-03 Impact factor: 4.600
Authors: Pilar Cristancho; Brendan O'Connor; Eric J Lenze; Daniel M Blumberger; Charles F Reynolds; David Dixon; Benoit H Mulsant Journal: Int J Geriatr Psychiatry Date: 2016-05-09 Impact factor: 3.485
Authors: Lauren D Garfield; Daniel J Müller; James L Kennedy; Benoit H Mulsant; Charles F Reynolds; Steven L Teitelbaum; Roberto Civitelli; David Dixon; Alexandre A Todorov; Eric J Lenze Journal: World J Biol Psychiatry Date: 2013-09-30 Impact factor: 4.132
Authors: Kerri S Rawson; David Dixon; Roberto Civitelli; Tim R Peterson; Benoit H Mulsant; Charles F Reynolds; Eric J Lenze Journal: J Am Geriatr Soc Date: 2017-05-26 Impact factor: 5.562
Authors: Marie Anne Gebara; Marcie L O Shea; Kim L Lipsey; Steven L Teitelbaum; Roberto Civitelli; Daniel J Müller; Charles F Reynolds; Benoit H Mulsant; Eric J Lenze Journal: J Am Geriatr Soc Date: 2014-07-15 Impact factor: 5.562
Authors: Jimena Laporta; Kimberly P Keil; Samantha R Weaver; Callyssa M Cronick; Austin P Prichard; Thomas D Crenshaw; Galen W Heyne; Chad M Vezina; Robert J Lipinski; Laura L Hernandez Journal: Mol Endocrinol Date: 2014-09-05