Osteoporosis Drug Linked to Depression and Anxiety

Osteoporosis Drug Linked to Depression and Anxiety

The osteoporosis drug alendronate increases the threat for depression more than 14-fold in folks aged 65 years and younger, and more than 4-fold higher in folks more aged 65 years and older. These findings have been published in Scientific Reports.

Investigators analyzed more than 15 million adverse drug occasion reports connected to person osteoporosis medicines from the Food and Drug Administration Adverse Events Reporting System (FAERS) database involving January 2004 and December 2020. People diagnosed exclusively with osteoporosis who have been taking osteoporosis medicines only have been chosen for the study in order to remove drug interactions and possible side effects with drug combinations from the evaluation.

People with osteoporosis have been divided by drug regimen: alendronate (n=7821), zoledronate (n=9367), risedronate (n=1168), ibandronate (n=3727), denosumab (n=15,812), and teriparatide (n=45,052). Researchers additional subdivided groups into these aged more than 65 years and these aged beneath 65 years to assess influence of age on adverse events (AEs).

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The researchers calculated reporting odds ratios (RORs) for depression and anxiousness for each and every of the 6 osteoporosis medicines. Compared with  the 5 other osteoporosis medicines, alendronate demonstrated considerably elevated odds ratios for each depression (ROR 14.67, 95% CI, 11.55-18.63) and anxiousness (ROR 7.10, 95% CI, 5.79-8.71) in men and women beneath 65 years old. Comparatively, risedronate showed a a lot decrease, but nonetheless statistically considerable, enhanced odds ratio for depression (ROR 3.06, 95% CI, 1.70-5.52) in these beneath 65 years old. In men and women older than 65, alendronate was the only osteoporosis therapy with elevated odds ratios for depression (ROR 3.60, 95% CI, 2.82-4.59) and anxiousness (ROR 2.28, 95% CI, 1.84-2.84) compared with the manage group.

To confirm their findings, the investigators compared information from the World Health Organization’s VigiAccess webpage–which reported considerably more AEs linked to  bisphosphonate use from more than 110 various countries–with information from the FAERS database. Again, alendronate exhibited larger ROR for each depression (ROR 4.33, 95% CI, 4.09-4.58) and anxiousness (ROR 3.14, 95% CI, 2.97-3.33) compared with other bisphosphonates. This second evaluation confirmed that alendronate maintained the strongest association with depression and anxiousness in the bisphosphonate class of medicines.

The study authors noted other research which highlighted a hyperlink involving alendronate and psychological AEs. One study described alendronate’s inhibition of protein tyrosine phosphate receptor kind S and kind E (PTPRS and PTPRE, respectively) and the considerable association involving PTPRS and other receptors  and big depression.

The investigators acknowledged many study limitations, which includes the voluntary nature of FAERS reporting which “does not represent the true population of actual cases and AE frequencies due to underreporting and focus on more severe AEs.” Additionally, the study focused solely on monotherapy for osteoporosis, potentially overlooking info about comorbidities and drug interactions with more than-the-counter medicines.

 ‘We located that alendronate had the biggest and statistically considerable association with depression and anxiousness out of all bisphosphonates,” the researchers concluded, additional noting their findings have been supported by VigiAcccess and WHO evaluation, but emphasizing their findings nonetheless essential controlled trials to confirm clinical causality.


Keshishi D, Makunts T, Abagyan R. Common osteoporosis drug associated with increased rates of depression and anxiety. Sci Rep. 202111(1):23956. doi:10.1038/s41598-021-03214-x

This write-up initially appeared on Endocrinology Advisor

Originally published in www.psychiatryadvisor.com