Study Raises Questions on Antidepressant-Hip Fracture Link

January 11, 2019

A new cohort study confirmed a previously reported association between treatment with antidepressants and hip fracture in older adults, but it contained a twist: it showed an association was present a year before antidepressant therapy started.

Researchers published results from their investigation online in JAMA Psychiatry.

“This finding raises questions about the association that should be further investigated in treatment studies,” researchers wrote.

Algorithm Predicts Antidepressant Response

The study included 408,144 adults aged 65 years and older. Older adults prescribed antidepressants were matched by age and sex to a control participant without antidepressant prescriptions. Researchers looked at the incidence of hip fractures the year before the first prescription for an antidepressant was filled and through the year afterward.

Older adults who used antidepressants sustained more than double the number of hip fractures of older adults who did not use antidepressants—both the year before and after antidepressant initiation, researchers reported. The rate of hip fractures the year before the first prescription was filled was 2.8% in older adults who used antidepressants, compared with 1.1% in matched controls. In the year after, the hip fracture rate was 3.5% in those who used antidepressants, compared with 1.3% in matched controls.

The odds ratios were highest 16 to 30 days before antidepressant initiation, researchers added. The pattern was consistent for all patient subgroups and antidepressants studied.

—Jolynn Tumolo


Brännström J, Lövheim H, Gustafson Y, Nordström P. Association between antidepressant drug use and hip fracture in older people before and after treatment initiation. JAMA Psychiatry. 2019 January 2;[Epub ahead of print].