According to research, women who take SSRI antidepressants during pregnancy or breastfeeding could be at risk for bone loss. What's a women with depression to do?
The safety of taking antidepressants during pregnancy has been debated more than once—but now there may be reason to discuss the possible dangers of taking antidepressants after pregnancy, too.
According to a recent study from The Endocrine Society, selective serotonin reuptake inhibitors (SSRIs), which are the most commonly prescribed class of antidepressants, cause decreased bone density in pregnant and breastfeeding mothers—and this may put them at higher risk of broken bones later in life.
Nursing, SSRIs and bones
This research builds on previous studies, which found a link between SSRI use and decreased bone density and increased susceptibility to bone fractures. The current study, however, looked at how this effect manifests in lactating moms—women who don't take SSRIs already lose 6 to 10 percent of bone mass while nursing, as calcium in the body moves from bone mass to the breast milk. While most women who breastfeed recover that lost bone mass after they stop nursing, it's important that we understand whether or not SSRI use can compound the effect.
"SSRIs are the most widely prescribed class of antidepressants, particularly during pregnancy and breastfeeding," Laura Hernandez, Ph.D., the study's principal investigator said. "Therefore, it is of paramount importance that we explore the possibility that SSRIs may have detrimental effects on long-term maternal bone health."
The role of folic acid
In order to observe this relationship, Hernandez and her team gave six mice SSRI antidepressants during pregnancy and lactation. They compared these mice to six others who received saline instead of the drug. Two other groups of mice were fed high doses of folic acid—half of these were given antidepressants, the other half took saline.
Hernandez assessed bone mineral density on the 10th day of lactation, finding that SSRI consumption did have a negative effect on bone density—but the folic acid tended to reverse this effect when taken in high doses. "Women who are breastfeeding may need more folic acid to protect against bone loss," Hernandez said. Does that mean that taking high doses of folic acid could completely reverse bone loss due to the compounded effects of lactation and SSRI use? It's too early to say. According to the study's release, the long-term effects of taking SSRIs while breastfeeding are still unknown. After all, many women who take antidepressants do so before hitting menopause, when bone loss tends to accelerate.
"This could be a big problem for a large population," Hernandez said.