Figure - PMC

Skip to main content

An official website of the United States government

Here's how you know

Here's how you know

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

View full-text article in PMC

. 2020 Mar 17;68(7):1494–1503. doi: 10.1111/jgs.16404

Search in PMC
Search in PubMed
View in NLM Catalog
Add to search

© 2020 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

PMC Copyright notice

Association between antidepressant use and the risk of fractures overall, by therapeutic class, and by drug. Any antidepressant use: In each jurisdiction, we first modeled periods of any antidepressant use vs periods of nonuse using time‐dependent measures of exposure, and adjusted for age, sex, potential treatment indications (depression, anxiety, other mental health issues, pain), conditions that increase the risk of falls (dementia, Parkinson's disease, epilepsy, hypertension, peripheral vascular disease, obesity) and fractures (cardiac problems, stroke, renal disease, cancer, osteoporosis, history of fracture), and concurrent drugs (as time‐dependent exposures, benzodiazepines, antipsychotics, opioids). By class: In each jurisdiction, we estimated a second model, where antidepressant exposure was measured as a time‐varying covariate by therapeutic class (SSRI [selective serotonin uptake inhibitor], SNRI [serotonin norepinephrine reuptake inhibitor], TCA [tricyclic antidepressant], atypical, multiple classes), using binary on (1)‐off(0) indicators to represent periods of use for each of the five mutually exclusive therapeutic classes. Periods of use were compared with pooled periods of nonuse across all classes. Models were adjusted for the same potential confounders listed for the any antidepressant model. By drug: In each jurisdiction, we estimated a third model, where antidepressant exposure was measured as a time‐varying exposure by individual drug. All drugs were included in the model, and binary on (1)‐off(0) indicators were used to represent periods of use. The estimated hazard ratios (HRs) represent risk during periods of use compared with pooled period of nonuse across all drugs. Models were adjusted for the same potential confounders listed for the any antidepressant model. HRs are shown when there were at least 300 or more users of a given drug within the respective jurisdiction. The error bars represent the 95% confidence intervals around the HRs. Mtl, Montreal; UK, United Kingdom.