Osteoporosis and SSRI

I went off antidepressants after being diagnosed with Osteoporosis. I am the only one in my large family with osteoporosis, but I also have asthma and was prescribed inhalers containing steroids for years so it could be a mix of several factors, including menopause. Indeed, research has linked SSRI’s to osteoporosis. The tricky part; many times antidepressants were prescribed during perimenopause especially during the era of the WHI rather than hormone replacement. Many of us in our 60’s and 70’s got this treatment and now pay the price. Buspar has been around a long time and has been proven to be effective in treating anxiety. All we can do now is move forward. I wish you the best in your bone health journey.

@lhankins Thank you for sending me a reply. Yes, I know women who were told SSRI's would help them manage their menopausal anxiety and hot flashes. They were told HRT was too risky so they took these other meds instead. They probably would have been better off on HRT, but now it's too late since they are 10 years post menopause. I feel as if we've been let down badly by the medical community. I really wish there were better treatment options.

@soggybones
Women’s health care has been neglected writ large. I have had to work very hard to get past the anger I first felt when originally diagnosed; then the frustration of the medical model for prescribing designer drugs that fail to provide a long term solution for many people. Maybe a silver lining in all of this is that women are becoming more proactive in their approach to their overall health and longevity. I know my daughter and her friends have benefited mightily from my experience and my hope is this next generation coming up will be much better informed at an earlier age thereby avoiding what many of us experienced. For now, we simply march on and do the best we can to help each other.

@lhankins Yes. My daughters and nieces are all aware of how they can avoid the same fate as us. I am optimistic that future generations will have better options than us. That's the only bright spot. As for us....well, we just do the best we can with the hand we've been dealt.

I had depression and was going through menopause 26 years ago, when I began taking an SSRI. A year ago I was diagnosed with osteoporosis after I broke my wrist. I started on HRT 8 months ago at the age of 74. I know that is a bit risky, but my sister who is 4 years older than me has been on HRT since menopause and she does not even have osteopenia. A month ago I stopped taking my SSRI. I have tried that many times before and then started taking it again when I got annoyed all the time! So far, I feel fine. I am hoping that the HRT is taking the place of the SSRI. I also avoid caffeine, alcohol. I take D3 and calcium and walk walk walk. The next step is to get a Dexa scan. What else can I do? Looking for your advice.

@seapen
I have been reading in these posts about women who in their 70s are now taking or considering HRT for bone health management. I, too, wondered if it would work for me after a ‘session’ of Tymlos. Still will ask the question after my 18 months are up on it. So a whole generation missed out on the benefits of HRT because of the risks. I wonder if this new generation and folks on GLP-1 therapy are not going to experience issues with bone health as well given how nutrition and bone health are so closely woven together. I’m sure there are no long-term studies that address this as yet but I feel that as knowledge is gained we’ll find that it will become another avenue of bone health that will have to be dealt with. Live and learn!

@seapen Do you know what your T-score is? I've heard of many women who have had good luck with HRT managing their osteoporosis and anxiety. I stopped taking my SSRI, but have continued to take trazadone (a SARI instead of a SSRI) for days when I have trouble sleeping. I have been told that progesterone often helps with sleeping and estrogen will help with bone density and everything else. I decided not to take traditional HRT because I'm in a high risk category for breast cancer and HRT would increase that risk slightly....well, my risk is already high enough so I really don't want even a slight increase in my risk! I also have some mild coronary artery disease so that's another thing that would make HRT a not so great option. I'm currently trying Duavee since it is believed to not increase my risk of breast cancer. I still have the risk of blood clots and stroke because it is an oral estrogen, but a study looking at the incidence of stroke/heart attack with Duavee found no difference in the group treated with Duavee vs. the placebo group. It's a gamble, but every treatment option is. This is what I've decided for myself. For other women with excellent cardiovascular health and a lower risk of breast cancer I think HRT is a great choice-even if they are older.

@dorob I wonder about that too. I know a lot of people jumping on the GLP-1 bandwagon and they are losing a lot of weight. I wonder if we'll find out somewhere down the road that GLP-1's aren't so great after all. It reminds me of the time when everyone was taking fossamax-even those with just osteopenia because everyone thought it was great and you could be on it forever. Well, we all learned the hard way that it is not a drug you want to be one forever and it does come with some rather serious side effects.

I was told that my taking sertraline (generic for Zoloft) could have been a factor in my "Severe Osteoporosis" diagnosis (just recently @ 62 years "young").
My other relevant factors that I believe had more of a contribution are being small-framed, not taking HRT at menopause onset (because it was not advised at the time), and just recently having my first DXA scan.

I've tried Buspar in the past, and it made me exhausted and didn't seem to do the trick.
However, each individual responds differently.
Just make sure you taper off whatever you're taking extremely slowly if you decide to switch.

Ironically, it was perimenopause that kicked me into the need for a magic pill to take the edge off sadness and new anxiety (which I never had before my hormones took a nosedive).
Turns out estrogen balanced with progesterone is beneficial to prevent bone loss, help with mood swings, and sleep...who knew?!
I recently had the late HRT discussion with my GYN and she prescribed the estrogen transdermal gel as well as oral progesterone.
Honestly, I have yet to start this regimen (and may not) as I'm still in my "Cardiac Clearance" process for Evenity, and I don't want to try to many new meds at once so I may truly pay attention to the affects of just one at a time.
I tend to have low BP and my bone specialist would prefer Evenity for me over Tymlos for that reason.

For me, I feel like I need to continue the sertraline due to still being overwhelmed by my diagnosis, although I'm determined to move forward and strengthen my foundation.

@andi77 Thank you for sharing your story. Sometimes I feel so alone in this. Best of luck with the Evenity, I know there are a lot of people out there who have had great results with it and it should get you "out of the hole" very quickly. Have you experienced any fractures yet? I did taper off of my sertaline and I haven't taken it for about 4 weeks now. I feel fine most of the time, but sometimes I do start feeling anxious again-especially at night when I'm all alone in the dark. That's when I take a trazadone and have a little to eat and then I can sleep. Like you, I'm overwhelmed by this diagnosis but I am determined to fight it as best I can.