J Bone Miner Res

Do SSRIs increase fracture risk in midlife women?

September 18, 2025

Initiation of SSRIs in midlife women is associated with a significantly increased risk of fracture, independent of bone mineral density (BMD) and depressive symptoms. These findings underscore the importance of fracture risk assessment and bone health monitoring when prescribing SSRIs to women in this demographic.

Study details: A longitudinal analysis from the Study of Women’s Health Across the Nation (SWAN) evaluated fracture risk among 1,849 midlife women initiating SSRIs, other antidepressants, or no antidepressants. The study uniquely incorporated serial assessments of BMD and depressive symptoms, with annual follow-up for medication use and fracture incidence.

Results: Women starting SSRIs had a higher incidence of any fracture (2.64 per 100 person-years; 95% confidence interval [CI], 1.82–3.71) compared with non-users (1.21 per 100 person-years; 95% CI, 1.07–1.36). Fully adjusted Cox regression models, accounting for BMD and depression severity, showed a hazard ratio of 1.77 (95% CI, 1.15–2.74) for any fracture in SSRI initiators vs. non-users. This elevated risk persisted for non-traumatic fractures and in subgroups with BMD data.

Source:

Solomon DH, et al. (2025, August 4). J Bone Miner Res. The Risk of Fracture Among Women Starting Selective Serotonin Reuptake Inhibitors. https://pubmed.ncbi.nlm.nih.gov/40757575/