Antidepressants and Osteoperosis

[Daisi124]

Does anybody know an antidepressent that will not affect bones. I am having a really bad time right now and the GP suggests anti depressants, he prescribed amitrypalene but after reading up about anti depressants they all seem to point to bone loss whichever one I look at? My spine result is very bad -3.8 T score.

[Mark_ABH]

Hi Daisi124, sorry to hear you are having a hard time. Amitriptyline is one of the older class of antidepressants called tricyclics (TCA). I am not aware that these medicines cause bone loss. The antidepressants that American Bone Health advises about are the newer ones called SSRIs (Prozac, Zoloft, Paxil, etc.). There are other classes of antidepressants besides those (SNRIs, etc.). Please ask your health care provider whether the medicine you have been prescribed will cause further bone loss, and whether that risk outweighs the benefit of the antidepressant. Your mental health is very important too!

Typically, the bone loss side effect depends on how much you take (dose) and how long you take it (duration). Are you taking any medicine to treat your osteoporosis?

More information about medicines that can cause bone loss. americanbonehealth.org/bone...

[Daisi124 in reply to Mark_ABH]

Thanks Mark and yes I take AA once per week.

[Mark_ABH in reply to Daisi124]

OK, that might cancel out bone loss from the mood medicine. Please discuss your concerns with your health care provider. Good luck!

[Fruitandnutcase]

Can I ask you Daisi124 did you feel depressed before you started AA or did that start after you started taking the AA?

[Daisi124 in reply to Fruitandnutcase]

Hi Hun, it is not anything to do with AA I have had some major life changing events in the last 18 months. My OH has advanced prostrate cancer kept at bay by hormone treatment ATM but incurable and I have been diagnosed with severe osteoporosis -4.8 in the spine. I am scared for the future and scared about dying as well. I am in the depth of despair but no I don't think it has anything to do with AA .

[Fruitandnutcase in reply to Daisi124]

Ah just wondered. I felt really bad while I took it then I felt like myself again when I stopped. I’m not surprised you feel scared you have a lot of difficult and scary things happening in your life at the moment. Discovering you have osteoporosis is pretty horrible and a T score of -4.8 isn’t good. Look after yourself.

[Lynnel17]

I will think of you today during my meditation and prayer time. May you feel safe.

[Daisi124 in reply to Lynnel17]

Thank you so much Lynne may God be with you

[Anonimoveneziano]

Hi Daisi124,

Your post of 3 years ago came up on my feed somehow today and it mentions Amitriptyline.

I just wanted to give you my account and my findings.

I have had osteoporosis for 15 years +, and currently on denosumab (14 doses in tot +3 zolandronade yearly infusions 2015 to 2018).

I have been suffering with low back pain for many years off and on, but nothing like since June 23, with now 3 episodes, currently on 3rd one where again had to be taken to A&E. Unable to stand, walk or sit, the back feels like shuttering, excruciating pains.

Current episode lower back pain lumber and mid toracic vertebral pains.

My REMS scores were -2.3 spine, -2.5 hip , - 2.5 femoral neck. June 24, (DXA values -.2.3 /-2.5/-3.1)

So since 2014 have gained very little even though on denosumab.

It would appear I have had no fractures so far, but the pain I am experiencing is unbelievable.

MRI scan 23 said DDD, L1 to S1, L2 nerve root impingement, and Modic changes type II..disks some dry, some dry and bulging on L1 L2 L3.L4L5 S1.

Now MRI scan last Friday denotes further deterioration, L2 out of line grade1 (25% degree) and hemangioma on L2.

Due to NHS restrictions guidelines while in a&e care, if in need of MRI scans, you only receive lower lumber MRI to exclude Cauda Equina.. ( told them I had pain up to my middle back. 😟)

I normally don't push the boat too out on painkilles because I am aware of bone loss and have done a lot of research.

I keep to paracetamol at the most alternating every 2 hrs with ipobrufen but to the min. because it is bad for bones too.

Cannot take codeine, morphine has provoked vagus nerve severe reactions with syncope and BP at low levels ( 70 over 40) body not just shaking but jumping loke a fit, lasting up to 1.5hrs. Luckily I was in hospital. So scary.

So at discharge from A&E was told to contact GP. Ended up with Amitriptyline 10 mg dose for nerve pain. The first time I took it I felt like large ants were crawling under my skull with intermittent sound of blood flashing through my ears drums. It took the pain away completely for few hrs. That was nice.

I told the GP and she never heard if it. So I looked at the liflet online and the full list that came through mentioned possible bone loss which I googled further into a reliable source of randomised research papers ( I read a lot of these ) which said that use of the med at relatively low doses has been found to provoke bone fractures. Since denosumab has also a black box warning of spontaneous vertebral, possibly hip fractures, I decided not to compound my probabilities of fracturing so I only use paracetamol and voltarol gel 2.32% just enough to take the edge off. I have been given diazepam for 2 days this time around. I have been again bed bound for 13 days today and worrying of bone loss due to inactivity, I cannot even sit on a chair to eat. I have been waiting to see a spinal consultant since July 23, just 1 apt with a very disengaged physio that sent a link to an A4 paper 6 exercises for legs. I can move my legs, if my back could stand up right... I am 66.