Do Antidepressants Cause More Hip Fractures?

With antidepressant use doubling in the last decade, medical professionals are concerned that we are becoming too reliant on them. Their use for depression and anxiety type illnesses are well documented — but they are used for many other conditions including pain management.

Now a study published in the British Journal of Clinical Pharmacology — Psychotropics and weak opioid analgesics in plasma samples of older hip fracture patients – detection frequencies and consistency with drug records — has found that older people who had fallen and suffered from a hip fracture used antidepressants more frequently than people in the general older population.

Norwegian blues

The team from Norway aimed to determine the use of psychotropic drugs in patients who had suffered from a hip fracture. Psychotropic drugs are legal or illicit drugs that can affect the mind, emotions or behaviour. Antidepressants and anti-psychotics are examples of legal psychotropic drugs — cocaine and cannabis are illicit psychotic drugs.

Rather than just relying on the use of questionnaires to record the use of antipsychotic drugs in the patients, the team instead used blood samples to provide more precise information and ensure the data was accurate. More than 250 hip fracture patients over 65 years of age were assessed and had their blood analysed by ultra-performance liquid chromatography with tandem mass spectrometry. The use of chromatography in analysing psychoactive drugs is discussed in the article, Tackling the chromatographic analysis of novel psychoactive substances with High Resolution Mass Spectrometry.

Can you believe the patients?

The reliance of questionnaires or patients’ memories are something that medical studies must either overcome or factor into the analysis. Not because patients are deliberately unreliable — although you might wonder how accurate the information given to doctors who ask, ‘How much do you drink in a week?’ is — but because reliable information is needed to make sure the study is accurate. As stated in a press release for the study:

The analysis measured drug levels in individuals’ blood samples, which provided investigators with a more precise measure than asking participants if they took the medications or examining their medical records. Indeed, the drugs were often present in these samples despite no information in patients’ medical records.

The analysis showed that the use of antidepressants and benzodiazepines in hip fracture patients was more frequent than in the respective prescriptive frequencies in the general population. The study also highlighted a lack of recording of the drugs on patients’ admission records — information that could be needed if surgery had to be performed.