In the current study, Kristine E. Ensrud, M.D., M.P.H., and her American colleagues investigated possible links between four classes of psychotropic medications (benzodiazepines, antidepressants, antiepileptic drugs, and narcotics) and risk for non-spinal bone fracture among a population of older women living in the community. The researchers surveyed 8,127 women, all 65 years or older.

During the average follow-up of 4.8 years, 1,256 women (15 percent) had at least 1 non-spinal fracture, including 288 women (4 percent) who had an initial hip fracture. When women who used a psychotropic agent were compared with women who did not use such a medication, women taking narcotics were almost 40 percent more likely to experience non-spinal fractures.

In addition, women who took antidepressants were almost 25 percent more likely have such a fracture. An analysis of women taking an antidepressant agent showed there were no differences in fracture rates between tricyclic antidepressants and selective serotonin reuptake inhibitors. Furthermore, researchers found that women taking antidepressants had a 70 percent increase in the risk for hip fracture compared with women who did not use any psychotropic medication.

In contrast, there were no significant associations between the use of benzodiazepines or antiepileptic drugs and risk of non-spinal fracture.

"We conclude that antidepressant use and narcotic use are independent risk factors for non-spine fractures in community-dwelling, elderly women and that older women taking antidepressants are at increased risk for hip fracture," wrote the authors. "Our findings suggest that preferential prescription of selective serotonin reuptake inhibitors instead of tricyclic antidepressants will not likely reduce the risk of fracture associated with antidepressant use in older people."