Abstract
The relationship between depression and osteoporosis is reciprocal. Depressive patients reveal lower bone mineral density and higher fracture risk due to "unhealthy" lifestyle, higher risk of falls, use of antidepressive medication and hormonal and mediator changes (particularly of serotoninergic system), respectively.
SSRI (selective serotonin reuptake inhibitors) are considered to be the most risky regarding osteoporosis risk; fracture risk steeply increases at the beginning of the treatment due to vegatitive disturbances, after adjustment of autonomic nervous system fracture risk mildly increases with the lenght of the treatment due to impact of SSRI on bone mineral density mediated by serotoninergic system. On the contrary, osteoporosis could emphasize depressive symptoms by its complications.
The relationship between depression and osteoporosis may imply some practical recommendations for screening of osteoporosis in a selected subgroup of depressive patients and osteologists should inquire about SSRI treatment when considering secondary pharmacology-induced osteoporosis, respectively.