Calarge CA, et al. – The experts analyzed the effect of major depressive disorder (MDD), generalized anxiety disorder (GAD), and selective serotonin reuptake inhibitors (SSRIs) on the changes in bone metabolism in adolescents and emerging adults. They concluded that MDD and GAD were associated with increased bone mass, particularly in the lumbar spine (LS) and in females. Whereas, SSRIs were associated with increased bone mass in females but decreased bone mass in males.

Methods

• The experts reviewed the medically–healthy 15 to 20 year–olds who were unmedicated or within one month of starting an SSRI.
• Psychiatric functioning and medication treatment were evaluated monthly.
• Every 4 months, trabecular and cortical volumetric bone mineral density (vBMD) at the radius and markers of bone metabolism were analyzed.
• Total body less head areal bone mineral content and LS areal BMD were evaluated, every eight months, .
• Linear mixed effects regression analysis examined associations between bone measures on the one hand and MDD, GAD, and SSRI indices on the other.

Results

• 264 participants were followed for 1.51 ± 0.76 years.
• MDD severity was associated with increasing LS aBMD, after adjusting for age, sex, vitamin D concentration, physical activity, lean mass or grip strength.
• Similarly, SSRI use was associated with increasing LS aBMD and bone formation in female participants.
• Whereas, SSRI use was associated with decreasing LS aBMD in males.
• After accounting for depression, GAD was independently, albeit weakly, associated with increased bone mineralization.