Psychotropic drugs linked to fracture risk

JAMA Psychiatry. 2017. doi:10.1001/jamapsychiatry.2017.0449

Psychotropic medications seem to increase the risk of a major osteoporotic fracture, according to a study that followed 62,275 women and 6455 men aged, on average, 64.2 years for a median of 6.7 years.

Of these, 13.1% died, 8.4% sustained an incident major osteoporotic fracture (MOF) — such as hip, vertebral, humerus, or forearm — and 2.3% experienced an incident hip fracture.

FRAX estimates the 10-year probability for an MOF (see www.shef.ac.uk/FRAX/tool.jsp). More than 100 guidelines worldwide for osteoporosis management include FRAX. After adjusting for FRAX score and previous use of medicines for osteoporosis, depression increased the risk of an MOF by 39% and hip fracture by 43%. Schizophrenia increased the risk of an MOF by 82% and more than doubled the risk of hip fracture (hazard ratio 2.34). Anxiety increased the risk of an MOF by 19%. The 8% increase in hip fracture risk in patients with anxiety was not statistically significant.