Can long-term use of SSRIs possibly contribute to osteoporosis?

Hello @dancingtree and welcome to Mayo Clinic Connect.

I'm glad that you posted your question about SSRI meds and bone loss. I have also taken various anti-depressants for many years but have never heard about any side effects of bone loss associated with these meds. It is important when you read an article to be sure that the source of the article (author, publisher, etc.) is reliable from a scientific/medical standpoint.

I've been told by GI doctors that meds that reduce stomach acids called PPIs (these include products like Nexium, Prilosec, etc.) which are in the class of PPI can cause bone loss over the years. Perhaps you have taken these meds as well?

As I also have bone loss and have recently started taking Actonel, I'm wondering what type of life style changes you have made in order to help reduce bone loss. I'm thinking of activities such as a diet high in calcium, also Vit D3 supplements, and weight-bearing exercises like walking.

I look forward to hearing from you again. Will you post an update?

I found the information connecting SSRIs to osteoporosis, which also mentioned the connection with PPIs, on bottomlineinc website.
It was mentioned in the section about men and osteoporosis. I intend to do more research on this since I have been on Venlafaxine for so many years, my main concerns are long term effects and damage to the brain serotonin receptors as well as other systems. Thanks for your reply.

@dancingtree Thanks for the update. Would you please let me know if you find other sources that relate to anti-depressants and bone loss? Thanks!

Dancingtree, I was diagnosed with osteoporosis when I was 35. Ridiculously young. I'm not 73. Back when I was diagnosed, few docs knew much about it and certainly not for a young woman like me. One doctor came to town, neurologist, put me on oyster shell calcium supplement. Helped me then.A few years ago, I was diagnosed with a very low 'D' and 'B', so I take D3, Super B Complex, daily vitamin and B12 shots every 2 weeks. That's a lot, but my body needs the help with these things. It's working nicely. I have only slight osteoporosis, normal for my age. Of course, I'm dealing with the damage of the years before we found answers, but I love the answers! I walk when I can, go to the therapy pool for water 'exercise' 2X weekly.....94 degree temp that takes away ALL my pain, the only time I'm truly pain free....walk, do all kinds of simple things to get moving w/water resistance. Wow, has it helped me all over. Maybe time in a regular pool will give you the resistance your bones need to strengthen.....Also, I eat yogurt daily...helps my tummy, too. hope you find some answers. BTW: I've gotten really picky what sites I use for research, for info re my issues. I now only use top, reputable sites, like Mayo, Cleveland Clinic, Univ. Florida, Boston Clinic, the major health sites. Seems better for me.....

I think that I will up all the essential supplements for my bones and see how that effects my next dexa scan before going on a new level of osteoporosis medication. I may also slightly reduce the Effexor and see if I can tolerate a lower dose. I do take a micro dose of melatonin at night for sleep. I cannot tolerate anything over 1mg without getting terrible nightmares.

Hello @dancingtree

A fellow mentor on Connect has provided me with some additional research (from some reliable websites) about the connection between SSRIs and bone loss. Here are the links to those articles, "Selective serotonin reuptake inhibitors (SSRIs) account for approximately 62% of all antidepressants prescribed in the United States. There have been several recent studies suggesting that SSRIs may lower bone mineral density in individuals over the age of 65. Jun 17, 2018"

— Antidepressants and Risk for Osteoporosis: https://womensmentalhealth.org/posts/antidepressants-and-risk-for-osteoporosis/

SSRIs: Bad to the Bone? – NCBI – NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442753/

Here is another discussion on Connect which shows that regular use of prednisone (steroids) can also cause bone loss,.

Hello Dancingtree, you are the first person I've ever heard of beside myself, That doesn't tolerate melatonin very well. It has been known to give me insomnia. May I ask what dose of it you are taking? I have only seen it in a 3 mg that is that's the lowest milligram I have seen. And I don't think they are scored for easy breaking in half. I hope your plan works for you. Please keep us posted. I am struggling with the same situation that is osteoporosis. Warmest wishes, Sunny flower

That could be me. An article from the National Institute of Health which appears in the publication National Institute of Medicine says that it can cause osteoporosis. I have taken Effexor for many years. Now I have osteoporosis. As of today my doctor said there is no connection. Here’s a quote from that article.
“Epidemiologic data suggest older adults receiving serotonergic antidepressants may have accelerated bone loss. We examined bone turnover marker changes and patient-level variables associated with these changes in older adults receiving protocolized antidepressant treatment.“

And, PS. I am very slowly weaning off. I am finally down to the lowest dose. I took about two years. VERY slowly. I went through some stress recently and bumped up to the next highest dose for about four months and am now back down to the lowest. Listen to your body. Go slow.

Regarding Effexor causing bone loss, the National Institute of Health stated in an article in the National Institute of Medicine that it can.

“Epidemiologic data suggest older adults receiving serotonergic antidepressants may have accelerated bone loss. We examined bone turnover marker changes and patient-level variables associated with these changes in older adults receiving protocolized antidepressant treatment.“

The same can be found in numerous other reputable articles and institutions.