Brännström J, et al. - Researchers conducted a nationwide cohort study to examine the association between antidepressant drug treatment and hip fracture starting 1 year before the initiation of treatment. Outcomes support the association between antidepressant drug use and hip fracture in the year before and year after the initiation of treatment. All studied antidepressants and subgroups displayed the pattern consistently.

• From the Prescribed Drugs Register of Sweden’s National Board of Health and Welfare, researchers matched 204,072 individuals, aged 65 years or older, who had a prescription of antidepressants filled between July 1, 2006, and December 31, 2011, by birth year and sex to 1 control participant who was not prescribed antidepressants (for a total of 408 144 people in the register).
• Collection of outcome data was done from 1 year before to 1 year after the index date (date of prescription being filled).
• From July 1, 2005, to December 31, 2012, they performed data analysis.
• They determined the incident hip fractures occurring in the year before and year after initiation of antidepressant therapy, and investigated the associations using multivariable conditional logistic regression models and flexible parametric models.

• This study included 408,144 people; 257,486 (63.1%) women; mean (SD) age 80.1 (7.2) years.
• Researchers observed more than twice as many hip fractures among antidepressant users as that observed among nonusers in the year before and year after the initiation of therapy (2.8% vs 1.1% and 3.5% vs 1.3%, respectively, per actual incidence figures).
• In adjusted analyses, they noted highest odds ratios for the associations between antidepressant use and hip fracture 16 to 30 days before the prescription was filled (odds ratio, 5.76; 95% CI, 4.73-7.01).
• In all separate analyses of age groups, of men and women, and of individual antidepressants, the odds ratios were highest 16 to 30 days before initiation of treatment, and there was no clear dose-response relationship.