Leo Sher, M.D.

A research paper, “Common osteoporosis drug associated with increased rates of depression and anxiety” has recently been published in Scientific Reports (1).

Amongst the most common drug therapies for osteoporosis are bisphosphonates, including alendronate, zoledronate, ibandronate and risedronate. Other first-line options with a different molecular mechanism include denosumab and teriparatide.

The author quantified the association of alendronate and other bisphosphonates with depressive symptoms by analyzing over 100,000 adverse events reports from the Food and Drug Administration Adverse Events Reporting System (FAERS) and the World Health Organization’s (WHO) global database for adverse drug reactions (ADRs) VigiAccess. The study used de-identified datasets. People with osteoporosis were 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 subdivided study participants into those aged over 65 years and those aged under 65 years to assess influence of age on adverse events.

The authors found that alendronate therapy is significantly associated with depression and anxiety when compared to other first-line osteoporosis treatments. The reported risk of depressive ADRs was found to be over 14-fold greater in patients taking alendronate under the age of 65 and over fourfold greater for patients over 65 compared to the control. The authors suggest that controlled trials are necessary to adjudicate the clinical causality.

References

1. Keshishi D, Makunts T, Abagyan R. Common osteoporosis drug associated with increased rates of depression and anxiety. Sci Rep. 2021 Dec 14;11(1):23956. doi: 10.1038/s41598-021-03214-x.