Posted by Quintal on August 21, 2007, at 20:43:11
In reply to Re: SSRIs and bone loss, posted by linkadge on August 21, 2007, at 20:26:09
>For instance, if there was a noradrenergic link to bone loss too, then higher doses, or more relative affinity for norepiniehprine reuptake might be important. (The study lary posted, for instance, said that stress induced bone loss could be prevented by beta adrenergic receptor blockade). So beta adrenergic receptor agonism might be a factor.
Yeah, I saw that too, and when you consider that the secondary-amine TCAs desipramine and nortriptyline are strongly noradrenergic that might explain the higher incidence of hip fracture relative to the tertiary-amine TCA group, but not the SSRI group, unless the SSRIs used were the more strongly noradrenergic ones, like Prozac, and used at high doses. The study says "The proportion of current use in the low-dose range was 22% for SSRIs, 50% for secondary-amine TCAs, and 58% for tertiary-amine TCAs.". So most of the SSRI group were in the moderate-to-high dose range (possibly due to greater tolerability at high doses)? The tertiary-amine group were exposed to the lowest doses out of the three groups. So there may be at least some correlation between dose and risk of hip fracture, and that may be just as important as drug class.
Q
poster:Quintal
thread:777598
URL: http://www.dr-bob.org/babble/20070815/msgs/777685.html