Evidence map›Paper›PMID 39441436›Full record

ArticleArchives of osteoporosis2024

Risk of osteoporotic fractures in menopausal women with common mental health diagnoses prescribed SSRIs/SNRIs: cohort and self-controlled case series analyses.

Dana Alsugeir, Matthew Adesuyan, Christina Avgerinou, Vikram Talaulikar, Li Wei, Ruth Brauer

Abstract read
In one paragraph

Article in Archives of osteoporosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. The risk of fracture among women starting selective serotonin reuptake inhibitors.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025
    Article
4 · The record

Corrections and comments

  • AssociatedDataset
5 · Who and what money

Authors and funding

6 authors.

Dana AlsugeirResearch Department of Practice and Policy, UCL School of Pharmacy, BMA House, Tavistock Square, London, WC1H 9JP, UK.
Matthew AdesuyanResearch Department of Practice and Policy, UCL School of Pharmacy, BMA House, Tavistock Square, London, WC1H 9JP, UK.
Christina AvgerinouDepartment of Primary Care and Population Health, University College London, London, UK.
Vikram TalaulikarReproductive Medicine Unit, University College London Hospital, London, UK.
Li WeiResearch Department of Practice and Policy, UCL School of Pharmacy, BMA House, Tavistock Square, London, WC1H 9JP, UK.
Ruth BrauerResearch Department of Practice and Policy, UCL School of Pharmacy, BMA House, Tavistock Square, London, WC1H 9JP, UK. r.brauer@ucl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In a population-based cohort study of menopausal women with common mental health diagnoses, SSRIs/SNRIs were associated with a 32% increased risk of osteoporotic fractures. The risk of osteoporotic fractures was particularly increased for longer periods of treatment with SSRIs/SNRIs (> 5 years) and in younger menopausal women (< 50 years old). PURPOSE: To investigate the association between selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) and the risk of osteoporotic fractures (OF) in menopausal women with common mental health diagnoses (CMHD).

methodsWe conducted the study with two designs (cohort and self-controlled case series [SCCS]), using the IQVIA Medical Research Database (IMRD) UK. The source population comprised women aged ≥ 50 years and women with a record indicating menopause (< 50 years). All women had a recorded CMHD. For the cohort analysis, the risk of OFs was estimated by comparing women prescribed SSRIs/SNRIs (exposed) to those not exposed. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CIs). For the SCCS, women acted as their own controls; periods of exposure to SSRIs/SNRIs were compared to periods of non-exposure using conditional Poisson regression to estimate incidence rate ratios (IRR) with 95% CIs.

resultsWe identified 292,848 women, of whom 35,222 experienced OFs within a median follow-up of 6.01 years. We found strong evidence of an association between SSRIs/SNRIs and the risk of OFs (adjusted HR = 1.32, 95% CI:1.29-1.35). Compared to periods of no exposure, SSRIs/SNRIs increased the risk of OFs during the first 30 days (IRR = 1.38, 95% CI:1.26-1.51), during the first 90 days (IRR = 1.58, 95% CI: 1.48-1.69), and the remaining exposure (IRR = 1.42, 95% CI:1.37-1.48).

conclusionsIn a population of menopausal women with CMHDs, the prescribing of SSRIs/SNRIs antidepressants was associated with a higher risk of OFs. Careful assessment of osteoporosis risk needs to be considered when treating menopausal women with SSRIs/SNRIs antidepressants.

Indexed as

MenopauseOsteoporotic FracturesSelective Serotonin Reuptake InhibitorsAgedCohort StudiesFemaleHumansMental DisordersMiddle AgedRisk FactorsSerotonin and Noradrenaline Reuptake InhibitorsUnited KingdomSelective Serotonin Reuptake InhibitorsSerotonin and Noradrenaline Reuptake InhibitorsFracturesMenopausalOsteoporosisSSRIs/SNRIs

Identifiers

PMID39441436
PMCPMC11499393

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.