Adults 50 years and older who use selective serotonin reuptake inhibitors (SSRIs) on a daily basis may be at twice the risk for clinical fragility fractures and at twice the risk for falls as those who don't, according to the results of a prospective cohort study of 5,008 randomly selected community-dwelling adults.  

The authors of the study calculated a hazard rate for incident clinical fragility fracture of 2.1 (95% CI, 1.3–3.4) and an odds ratio for falls of 2.2 (95% CI, 1.4–3.5) in those subjects taking SSRIs daily. Daily SSRI use was also associated with lower bone mineral density (BMD) at the hip and a trend toward lower BMD at the spine. The effects were dose-dependent and largely the same at baseline as they were 5 years later.  

It remains unclear whether the associations are due to a direct effect of SSRIs on bone physiology, to an increased risk of syncope when taking the agents, or to some combination of the two.  

Adults 50 years and older who use selective serotonin reuptake inhibitors (SSRIs) on a daily basis may be at twice the risk for clinical fragility fractures and at twice the risk for falls as those who don't, according to the results of a prospective cohort study of 5,008 randomly selected community-dwelling adults.