@article{d44017ce305c4bc7bb6d8ca81b2b436c,
title = "Bone Turnover with Venlafaxine Treatment in Older Adults with Depression",
abstract = "Objectives: Epidemiologic data suggest older adults receiving serotonergic antidepressants may have accelerated bone loss. We examined bone turnover marker changes and patient-level variables associated with these changes in older adults receiving protocolized antidepressant treatment. Design: Open-label, protocolized treatment study. Setting: Medical centers in Pittsburgh, St Louis, and Toronto. Participants: Older adults with major depression (N = 168). Measurements: Serum levels of the bone resorption marker C-terminal cross-linking telopeptide of type 1 collagen (CTX) and the bone formation marker procollagen type 1 N propeptide (P1NP) were assayed before and after 12 weeks of treatment with venlafaxine. Whether CTX and P1NP changes were associated with depression remission and duration of depression and genetic polymorphisms in the serotonin transporter (5HTTLPR) and 1B receptor (HTR1B) were also examined. Results: CTX increased and P1NP decreased during venlafaxine treatment, a profile consistent with accelerated bone loss. Two individual-level clinical variables were correlated with bone turnover; participants whose depression did not go into remission had higher CTX levels, and those with chronic depression had lower P1NP levels. HTR1B genotype predicted P1NP change, whereas 5HTTLPR genotype was unrelated to either biomarker. Conclusion: Bone turnover markers change with antidepressant treatment in a pattern that suggests accelerated bone loss, although the clinical significance of these changes is unclear. These data are preliminary and argue for a larger, controlled study to confirm whether antidepressants are harmful to bone metabolism and whether certain individuals might be at increased risk.",
keywords = "CTX, P1NP, antidepressant, bone turnover, depression",
author = "Rawson, {Kerri S.} and David Dixon and Roberto Civitelli and Peterson, {Tim R.} and Mulsant, {Benoit H.} and Reynolds, {Charles F.} and Lenze, {Eric J.}",
note = "Funding Information: Funding Source: This study was supported by MH083648 to all three sites, P30 MH090333 (University of Pittsburgh), the University of Pittsburgh Medical Center (Endowment in Geriatric Psychiatry (University of Pittsburgh)), the John A. Hartford Center of Excellence in Geriatric Psychiatry (University of Pittsburgh), Taylor Family Institute for Innovative Psychiatric Research, Barnes-Jewish Hospital Foundation, Washington University Institute of Clinical and Translational Sciences Pilot Award UL1TR000448 (Washington University School of Medicine), and the Campbell Family Mental Health Research Institute (Centre for Addiction and Mental Health, Toronto). Author Contributions: KSR, DD, TRM, RC, BHM, CFR, EJL: analysis and interpretation of data, preparation of manuscript. EJL: study concept and design, acquisition of subjects and data. Sponsor's Role: The sponsors of this study had no role in the design, methods, subject recruitment, data collection, analysis, or preparation of paper. Conflict of Interest: KSR, DD, and TRP have no financial disclosures. BHM receives research support from Brain Canada, the Canadian Institutes of Health Research, the U.S. National Institutes of Health (NIH), the CAMH Foundation, Eli Lilly (medications for a NIH-funded clinical trial), and Pfizer (medications for a NIH-funded clinical trial). Within the past 5 years, he has received research support from Bristol-Myers Squibb (medications for a NIH-funded clinical trial), Pfizer/Wyeth (medications for a NIH-funded clinical trial), Capital Solution Design LLC (software used in a study founded by CAMH Foundation), and HAPPYneuron (software used in a study founded by Brain Canada). Within the past 5 years, BHM has received travel support from Roche and directly owns stocks of General Electric (less than $5,000). CFR reports receiving pharmaceutical support for NIH-sponsored research studies from Bristol-Myers Squibb, Forest, Pfizer, and Lilly; receiving grants from the National Institute of Mental Health, National Institute on Aging, National Center for Minority Health Disparities, National Heart, Lung and Blood Institute, Center for Medicare and Medicaid Services, Patient-Centered Outcomes Research Institute, Commonwealth of Pennsylvania, John A Hartford Foundation, National Palliative Care Research Center, Clinical and Translational Science Institute, and American Foundation for Suicide Prevention; and serving on the American Association for Geriatric Psychiatry editorial review board. As of 2016, CFR assumed the role of Editor-in-Chief for the American Journal of Geriatric Psychiatry, for which he receives an honorarium. He has received an honorarium as a speaker from MedScape/WEB MD. He is the co-inventor and receives royalties from the (Licensed Intellectual Property) psychometric analysis of the Pittsburgh Sleep Quality Index (PRO10050447; PI: Buysse). RC owns stock of Amgen, Merck & Co., and Eli Lilly; has received consultant fees from Amgen; and has been on speakers{\textquoteright} bureaus for Amgen and Novartis. EJL receives support from Takeda, Lundbeck, Janssen, Alkermes, Taylor Family Institute for Innovative Psychiatric Research, McKnight Brain Research Foundation, Center for Brain Research in Mental Disorders, and Barnes/Jewish Foundation. Publisher Copyright: {\textcopyright} 2017, Copyright the Authors Journal compilation {\textcopyright} 2017, The American Geriatrics Society",
year = "2017",
month = sep,
doi = "10.1111/jgs.14936",
language = "English",
volume = "65",
pages = "2057--2063",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
number = "9",
}