Impact of selective serotonin reuptake inhibitors in the veteran population: 10-year risk outcomes

J Comp Eff Res. 2019 Apr;8(6):431-440. doi: 10.2217/cer-2018-0085. Epub 2019 Mar 11.

Abstract

Aim: To evaluate the comparative risk of hip fracture or osteoporosis among US Veterans based on selective serotonin reuptake inhibitor (SSRI) exposure.

Patients & methods: A retrospective cohort study of eligible US Veterans Health Administration patients enrolled in 2003-2004 was performed to examine SSRIs' 2-, 5- and 10-year impact on bone health using multiple logistic regression.

Results: Veterans on SSRIs were found to be 56.7% more likely over a 10-year period to suffer a hip fracture (risk ratio: 1.567; 95% CI: 1.464-1.676) and 34.6% more likely to develop osteoporosis (risk ratio: 1.346; 95% CI: 1.319-1.374) when compared with those who were SSRI naive.

Conclusion: SSRI usage was associated with greater risk of hip fracture and osteoporosis over a 10-year period in the veteran population, with similar effect sizes to smaller studies.

Keywords: SSRIs; citalopram; comparative risk; escitalopram; fluoxetine; fluvoxamine; fracture risk; paroxetine; risk factor; sertraline.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Comparative Effectiveness Research
  • Female
  • Hip Fractures / epidemiology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Osteoporosis / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • United States
  • Veterans*
  • Young Adult

Substances

  • Serotonin Uptake Inhibitors