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Olaf Schulte-Herbrüggen, MD; Ion Anghelescu, MD

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In the Editorial to the study "Use of Antidepressants and Rates of Hip Bone Loss in Older Women,"¹ Saag² claims that the possible causal negative effect of selective serotonin reuptake inhibitors (SSRIs) on hip bone mineral density should lead to a reevaluation and comparison of the risk-benefit ratio of SSRIs against first-generation antidepressants as well as alternative approaches such as newer drugs, psychotherapy, and even electroconvulsive therapy.

In our opinion, the data of the cross-sectional study by Diem et al¹ show a doubtful clinically significant increase of demineralization of the hip bones in older women treated with SSRIs, which is not clearly dose or time dependent of the medication used, and does not justify the consideration of tricyclic medication (TCA) instead of SSRIs. Apart from a reduced tolerability of TCA, these drugs exert higher amounts of life-threatening adverse effects such as cardiac arrhythmia, sudden . . . [Full Text of this Article]

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Use of Antidepressants and Rates of Hip Bone Loss in Older Women: The Study of Osteoporotic Fractures
Susan J. Diem, Terri L. Blackwell, Katie L. Stone, Kristine Yaffe, Elizabeth M. Haney, Michael M. Bliziotes, and Kristine E. Ensrud
Arch Intern Med. 2007;167(12):1240-1245.
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