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

Posted by dancingtree @dancingtree, Dec 3, 2020

I have been on 225mg venlafaxine (Effexor) for 25 years and I am now 68yo. I was diagnosed with osteoporosis about 13 years ago. I took a bisphosphonate for 5 years. Have been off for a few years now and my numbers went up again. Doc now wants to put me on Prolia. In my research I just read that taking SSRI antidepressants can contribute to osteoporosis. So I am thinking that this drug has given me a bone condition and now I need to take another drug to counteract it? I have tried to get off of venlafaxine a dozen times with very bad side effects. I kept asking my doctors what are the long term effects of taking this SSRI for so long and they didn’t seem to know anything. Also, they said that the severe side effects of going off meant that I needed to continue taking the drug! Anyone have an insight into this situation?

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@sunnyflower

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

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I started taking magnesium at night. I am sleeping better and while I have lowered my Effexor dose to the lowest one. Many people told me about magnesium at night and I figured it couldn’t hurt. I also take 50 mg of Trazodone at night. Trazodone doesn’t have the negative impact of many other sleep aids. I cannot take melatonin. Gives me nightmares and insomnia.

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Can someone post natural remedies for osteoporosis? I am weaning off of Effexor, can I recover any bone density. I exercise, do yoga, walk, and have now started weight resistance classes, I eat healthy and include calcium rich foods. I don’t smoke or drink. I take D supplements and my levels are good. I take multivitamins.

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To all asking this question. Dr Keith McCormack who recently wrote the GREAT BONES book speaks to SSRI’s being one of the risks along with others that impact negatively on bone status . He began fracturing at age 45 after while being a high level running athlete. (Like training for Olympic type things) . After that he took a deep dive and now his whole practice is consulting with people all over the US as to what direction they should take in addressing their bone status. I also am hooked up with a community of Integrative Practioners and all of them speak to the idea that SSRI ‘s are definitely a risk factor with bone health!!! Good luck to you all dealing with trying to decrease the level of meds of that nature!! 💕

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yes, antidepressants, specifically SSRIs can cause osteoporosis. Maybe others too but those are the most prescribed and most studied. I was on them for a couple of years many years ago and weaned off. Years later when I was diagnosed with osteoporosis, I did a deep dive into potential causes and was shocked to find that SSRIs were one possible link. Over the years, I have brought this up with numerous endocrinologists, gynecologists, internists and not one of them knew of this. Even a gynecologist specializing in menopause did not know of this connection. When I mentioned the correlation, each one of them told me, "no they're not" and I then asked them to look it up. A two second search told them this was in fact correct. I was shocked that not one doctor who prescribes this antidepressants knew of this risk factor and they were completely shocked to learn of it. Unbelievable.

A few years ago, I experienced a very challenging time in my life and of course, my doctor recommended an antidepressant. I asked them to check with the University's pharmacology staff to see if there were any options that did not have that correlation. They provided me with statistical evidence on the different types of antidepressants. It turns out that tricyclic (tetracyclic) antidepressants had only a very small risk of bone loss. They are older forms of antidepressants and not often prescribed because SSRIs and SNRIs have pretty much taken over the market. I felt comfortable taking Mirtazapine for a short while. It makes you sleepy (which I thoroughly enjoyed, being the insomniac that I am) so you take it at night. One issue with Mirtazapine is that your body may get used to it and need a higher dose at some point. But for short bouts of dealing with situational depression, I found it effective and was completely comfortable in the very, very low risk of potential bone loss. There may be other issues/risks with this drug, as with all, so would need to discuss with your doc if interested in it as an alternative.

@sunnyflower, if you are looking for a low-dose melatonin, you might try Herbatonin which is at .3 mg. Melatonin is sometimes more effective at low doses. We use it much higher doses in the US compared to other countries.

@llynch17056, if you want to try magnesium for sleep (or relaxation or easing muscle tension), you might try magnesiuml l'threonate or glycinate which do not have the bowel effects that citrate does (but if you want the bowel loosening effects in addition, citrate is the way to go)

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@teb

yes, antidepressants, specifically SSRIs can cause osteoporosis. Maybe others too but those are the most prescribed and most studied. I was on them for a couple of years many years ago and weaned off. Years later when I was diagnosed with osteoporosis, I did a deep dive into potential causes and was shocked to find that SSRIs were one possible link. Over the years, I have brought this up with numerous endocrinologists, gynecologists, internists and not one of them knew of this. Even a gynecologist specializing in menopause did not know of this connection. When I mentioned the correlation, each one of them told me, "no they're not" and I then asked them to look it up. A two second search told them this was in fact correct. I was shocked that not one doctor who prescribes this antidepressants knew of this risk factor and they were completely shocked to learn of it. Unbelievable.

A few years ago, I experienced a very challenging time in my life and of course, my doctor recommended an antidepressant. I asked them to check with the University's pharmacology staff to see if there were any options that did not have that correlation. They provided me with statistical evidence on the different types of antidepressants. It turns out that tricyclic (tetracyclic) antidepressants had only a very small risk of bone loss. They are older forms of antidepressants and not often prescribed because SSRIs and SNRIs have pretty much taken over the market. I felt comfortable taking Mirtazapine for a short while. It makes you sleepy (which I thoroughly enjoyed, being the insomniac that I am) so you take it at night. One issue with Mirtazapine is that your body may get used to it and need a higher dose at some point. But for short bouts of dealing with situational depression, I found it effective and was completely comfortable in the very, very low risk of potential bone loss. There may be other issues/risks with this drug, as with all, so would need to discuss with your doc if interested in it as an alternative.

@sunnyflower, if you are looking for a low-dose melatonin, you might try Herbatonin which is at .3 mg. Melatonin is sometimes more effective at low doses. We use it much higher doses in the US compared to other countries.

@llynch17056, if you want to try magnesium for sleep (or relaxation or easing muscle tension), you might try magnesiuml l'threonate or glycinate which do not have the bowel effects that citrate does (but if you want the bowel loosening effects in addition, citrate is the way to go)

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I have been taking magnesium glycinate at night without issues; thank you for the other info. When I asked my doctor about effexor causing bone loss, he said it didn’t, but he said he would research it. He came back and said that it did not. I lost so much confidence in him at that moment. I’m not going to argue about the reputable sources for that info, I may just gave to look for another doctor.

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@sunnyflower

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

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Hello. I take l mg. Melatonin. In a small capsule. Life Extension.

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This gives you a in-depth chart of multiple meds, such as SSRI Prozac, Zoloft and Paxil, that can cause Bone Loss. https://americanbonehealth.org/bone-health/medications-that-can-be-bad-for-your-bones-2/

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@llynch17056

I started taking magnesium at night. I am sleeping better and while I have lowered my Effexor dose to the lowest one. Many people told me about magnesium at night and I figured it couldn’t hurt. I also take 50 mg of Trazodone at night. Trazodone doesn’t have the negative impact of many other sleep aids. I cannot take melatonin. Gives me nightmares and insomnia.

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HomeAgainLA,
Would you please check which type of magnesium has helped you sleep? Oxide, tartare, glycinate, orotate, etc.? And which supplement manufacturer makes your magnesium? Unregulated by FDA, so many supplements don't contain what they claim they do.
I can fall asleep but can't sustain it for more than a couple of hours.

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I stopped fluoxetine (Prozac) for this very reason: high risk of bone breakage from severe osteoporosis. Was told to work on balance daily (to reduce risk of falls) because my bones are like toothpicks. This is after decades on Prozac. I'm 71. I've been taking Levothyroxine (Synthroid) for hypothyroidism which also takes a toll on bones. I bulk up on calcium rich foods throughout the day and have successfully lowered Levothyroxine dosage. Prolia was recommended. That is one expensive drug and the side effect profile was too scary for my risk averse self. You may want to ask your doc what the number needed to treat for Prolia is. The number needed to treat is a count of how many people need to be treated in order for one person to benefit. More effective meds have lower NNTs. Risk vs. reward calculation is a personal decision.

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@quinn

HomeAgainLA,
Would you please check which type of magnesium has helped you sleep? Oxide, tartare, glycinate, orotate, etc.? And which supplement manufacturer makes your magnesium? Unregulated by FDA, so many supplements don't contain what they claim they do.
I can fall asleep but can't sustain it for more than a couple of hours.

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I get it from Amazon. I take two capsules at night about an hour before I want to sleep.

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