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Use of SSRIs May Impact Bone Density in Adolescent and Young Women With Anorexia Nervosa

Published online by Cambridge University Press:  07 November 2014

Madhusmita Misra ,
Marie Le Clair ,
Nara Mendes ,
Karen K. Miller ,
Elizabeth Lawson ,
Erinne Meenaghan ,
Thomas Weigel ,
Seda Ebrahimi ,
David B. Herzog  and
Anne Klibanski
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Abstract

Objectives: Alterations in serotonin impact bone metabolism in animal models, and selective serotonin reuptake inhibitors (SSRIs) have been associated with increased fracture risk in older adults. SSRIs are commonly used in anorexia nervosa (AN), a condition that predisposes to low bone mineral density (BMD). Our objective was to determine whether SSRI use is associated with low BMD in AN.

Methods: We examined Z-scores for spine, hip, and whole body (WB) BMD, spine bone mineral apparent density, and WB bone mineral content/height (BMC/Ht) in females 12–21 years of age with AN who had never been on SSRIs, had been on SSRIs for <6 months (<6M), or had been on SSRIs for >6 months (>6M).

Results: Subjects on SSRIs for >6M had lower spine, femoral-neck, and WBBMD Z-scores than those on SSRIs for <6M. Hip BMD and WBBMC/Ht Z-scores were lowest in subjects on SSRIs for >6M. Duration of SSRI use, duration since AN diagnosis and duration of amenorrhea inversely predicted BMD, whereas BMI was a positive predictor. In a regression model, duration of SSRI use remained an independent negative predictor of BMD.

Discussion: Duration of SSRI use >6M is associated with low BMD in AN.

Conclusion: It may be necessary to monitor BMD more rigorously when duration of SSRI use exceeds 6M.

Type
Original Research
Information
CNS Spectrums , Volume 15 , Issue 9 , September 2010 , pp. 579 - 586
Copyright
Copyright © Cambridge University Press 2010

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