Медицинские услуги
© 2017-2021 Сайт «БЕЛМЕД.БАЙ», info@belmed.by
April 29, 2003 — Older women who take narcotics or antidepressants have a higher risk of experiencing a non-spinal bone fracture, according to an article in the April 28 issue of The Archives of Internal Medicine, one of the JAMA/Archives journals.
According to information in the article, use of medications that are active in the brain and spinal cord (i.e., the central nervous system or CNS) can impair alertness and neuromuscular function and may increase the risk of falls and fractures in older individuals.
Kristine E. Ensrud, M.D., M.P.H., of Veterans Affairs Medical Center, Minneapolis, and colleagues investigated whether the use of CNS-active medications including benzodiazepines, antidepressants, anticonvulsants and narcotics, increases the fracture risk in older, community-dwelling women. The researchers examined the use of these four medications in 8,127 women who were at least 65 years old. The women reported their current use of CNS active medications during interviews between 1992 and 1994 and between 1995 and 1996. The women were assessed for fractures using radiological reports until May 31, 1999.
The researchers found that during the average followup of 4.8 years, 1,256 women (15 percent) had at least one non-spine fracture, including 288 (4 percent) with first hip fractures. Compared with women not taking CNS-active medications, the women in the study taking narcotics were almost 40 percent more likely to experience non-spine fractures, and women taking antidepressants were almost 25 percent more likely to experience non-spine fractures. Among women using antidepressants, those taking tricyclic antidepressants and those using selective serotonin reuptake inhibitors (SSRIs) had similar fracture rates.
The researchers also found that women taking antidepressants compared with nonusers had a 70 percent increase in the risk for hip fracture. However, there were no significant associations between the use of benzodiazepine drugs or anticonvulsant drugs and risk of non-spinal fracture.
"We conclude that antidepressant use and narcotic use are independent risk factors for non-spine fractures in community-dwelling, elderly women and that older women taking antidepressants are at increased risk for hip fracture," write the authors. "Our findings suggest that preferential prescription of SSRIs instead of tricyclic antidepressants will not likely reduce the risk of fracture associated with antidepressant use in older people."