Vitamin Blue It isn't necessarily news that the problems associated with bone fractures create especially worrisome concerns for postmenopausal women. But a new study shows that for women who use antidepressant drugs, those concerns should be taken even more seriously. This just adds one more reason to consider natural and nutritional options before accepting anti-depressant medications. For over four years, researchers at the Veterans Affairs Medical Center in Minneapolis followed a group of more than 8,000 women over the age of 65 who were taking central nervous system (CNS) medications. The four types of prescription medications included in the study were: antidepressants (SSRIs such as Prozac and Paxil), pain-relief narcotics, anticonvulsants, and anxiety treatments (such as Xanax). When these women were compared to unmedicated women, the researchers found that the use of antidepressant and narcotic drugs significantly increased the risk of non-spine fractures, while the other two drug types apparently had little effect on the incidence of fractures. But when the statistics were isolated for antidepressant drug use alone, the result was shocking, revealing a 70 percent increased risk of hip fractures. These results were attributed to the probable impairment of mental faculties - one of the side effects of antidepressant drugs that often leads to accidents. So while it would be incorrect to say that bone fractures are a direct side effect of antidepressants, this study draws a clear association between the two for elderly women. I just happened to come across the Minneapolis study at about the same time I found another study that investigated the relationship of the B vitamin nutrient folate to depression. While other studies have already made the connection between depression and low levels of folate in clinical trials, this research - from the USDA Human Nutrition Research Center on Aging at Tufts University - is the first to study the association among a large segment of the general population. Researchers examined data from blood tests of almost 3,000 subjects, aged 15 to 39. Through diagnostic interviews, the research team found that subjects who had major depression and subjects who had mild depression both had low red blood cell folate concentrations. An editorial that accompanies the publication of the study in the journal Psychotherapy and Psychosomatics points out that while the results of this and other studies on folate and depression are promising, not enough research has been done to suggest a proper dosage for folate supplements, or exactly who should receive them, or for how long. Within the context of clinical research that sort of caution is expected. But out here in the real world it's not too early to recognize that someone who's depressed would almost certainly help their cause to include folate-rich foods in their diet, along with a supplement of folic acid.
Taken together, these two studies offer important considerations to any older woman who may be taking prescription antidepressants or weighing the option to do so. Will folate "cure" depression? That's doubtful. But folate provides a nutritious step in the right direction.
In the e-Alert "The Power Of The Single Word" (8/8/02) I told you how you about these dietary sources of folate: liver, asparagus, lentils, chickpeas, most varieties of beans, and especially spinach and other leafy green vegetables. Folic acid is the synthetic form of folate that you'll find in most multi-vitamins. And as I mentioned in that August e-Alert, when vitamins B6 and B12 are added to folic acid supplements, you may get the added benefit of a lower homocysteine level. And as if that weren't enough, folate may provide yet another benefit. In the May 2003 HSI Members Alert we told you how folate intake may help prevent breast cancer. According to a recent Harvard study, women with high levels of folate who also drank alcohol in moderation were 89 percent less likely to develop breast cancer than women whose folate levels were lowest. The advantage of a folate-rich diet isn't news to HSI members. But for any older woman who may be considering the use of a prescription drug to address depression, this new information about bone fracture risk will provide a fresh reminder that treating health problems with pharmaceuticals may open up dangers that don't always appear on the warning panel.
To Your Good Health, Jenny Thompson
Health Sciences Institute Sources:
"Central Nervous System Active Medications and Risk for Fractures in Older Women" Archives of Internal Medicine 2003;163:949-957, 4/28/03, archinte.ama-assn.org
"Antidepressants Raise Bone Fracture Risk" Jennifer Warner, WebMD Medical News, 4/28/03, content.health.msn.com
"Depression and Folate Status in the US Population" Psychotherapy and Psychosomatics 2003;72:80-87, content.karger.com
"Folic Acid May Ease Depression" Farret Condon, Hartford Courant, 6/5/03, ctnow.com
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