New research shows that selective serotonin-reuptake inhibitors (SSRIs) affect bone remodelling via two distinct mechanisms. In the short term (3 weeks), fluoxetine (the active compound in Prozac), has local anti-resorptive properties and increases bone volume. However, long-term treatment (6 weeks) offset the initial anti-resorptive effect and resulted in bone loss. Importantly, co-treatment with the β-blocker propranolol prevented the long-term effects of fluoxetine and, thus, bone loss. The findings highlight a possible strategy to counteract the increased risk of fractures with SSRI use.
References
Ortuño, M. J. et al. Serotonin-reuptake inhibitors act centrally to cause bone loss in mice by counteracting a local anti-resorptive effect. Nat. Med. http://dx.doi.org/10.1038/nm.4166 (2016)
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Holmes, D. Dual mode of action of SSRIs on bone remodelling. Nat Rev Endocrinol 12, 688 (2016). https://doi.org/10.1038/nrendo.2016.167
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DOI: https://doi.org/10.1038/nrendo.2016.167