What depression and broken bones have in common

Volume 13    |   Issue 57

I’ve talked a lot about antidepressants in the past. While I don’t think they’re always a bad option, I do think they’re prescribed far too frequently. I also think they’re prescribed for far too long. In fact, this is something that the FDA and I agree on.

Did you know that most antidepressants have FDA approval for only three months of use?

Yet doctors often prescribe them indefinitely. Many of them do this because they don’t know what else to do to treat depression. And they do it because they don’t realize the detrimental side effects some of these medications can have.

The majority of patients on antidepressants take a category of drug called selective serotonin reuptake inhibitors (SSRIs). These drugs affect the serotonin system and can help regulate mood. But that’s not the only system they affect. According to research published in the journal Bone, SSRIs also affect your bone mineral density.

Your brain has serotonin receptors, so that’s why SSRIs work to regulate mood. But your bones have these receptors as well. In fact, every major type of bone cell (osteoblasts, osteocytes, and osteoclasts) features serotonin receptors. Unfortunately, using SSRIs affects these receptors too – leading to bone mineral density loss and to osteoporosis.

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Because of this, researchers have linked use of both SSRIs and tricyclics to an increase in fracture risk. And it’s not a small increase. Your risk of a fracture can actually double if you take these drugs. The risk rises sharply as soon as you begin taking them and seems to peak after about a month for tricyclics and eight months for SSRIs. The good news is that the risk does decrease after you stop taking the drugs, but it takes about a year to get back to baseline.

The authors of this study suggest that SSRIs should be included in lists of medications that raise orthopedic fracture risk. I agree. But I think doctors should go a step further and try to limit their use of these drugs altogether. It really is possible. In fact, I’ve helped a number of patients transition off of SSRIs. There are many hormonal, dietary, and other natural therapies that can help.

If your doctor has told you that you’ll be on antidepressants for life and isn’t interested in exploring other solutions, I recommend that you find a new doctor. Find one who is willing to look at the wide range of natural options that won’t compromise one aspect of your health in hopes of benefitting another.

However, if you do decide to find a new doctor, make sure you continue following your old doctor’s instructions until you’re under the supervision of someone else. Stopping an antidepressant cold turkey can be very dangerous. You need the guidance of a medical professional to help you taper off slowly while finding alternative solutions that help you maintain both your physical and your mental health.

Yours for better health,




Bone. 2012 Sep;51(3):606-13. doi: 10.1016/j.bone.2012.05.018. Epub 2012 May 30.

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