Venlafaxine Use in the Elderly in Relation to Markers of Bone Metabolism

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Treatment of depression with venlafaxine is associated with increased levels of C-terminal cross-linked telopeptide (CTX) of type 1 collagen, a bone resorption marker, and decreased levels of N-propeptide (P1NP) of type 1 procollagen, a bone formation marker, according to a May 26 report in the Journal of the American Geriatrics Society, published online in the May 26 edition of the Journal of the American Geriatrics Society.

Kerri S. Rawson, Ph.D., of Washington University School of Medicine in St. Louis, and colleagues conducted an open-label treatment study of 168 elderly patients with major depression at medical centers in Pittsburgh, St. Louis, and Toronto. The authors examined serum CTX and P1NP before and after 12 weeks of venlafaxine treatment.

The researchers found that CTX increased and P1NP decreased during venlafaxine treatment. Patients whose depression did not remit had higher CTX levels and chronically depressed patients had lower P1NP levels; changes in P1NP were predicted by 1B receptor genotype, but serotonin transporter genotype was not associated with either biomarker.

Bone metabolism markers change in a pattern suggestive of accelerated bone loss with antidepressant treatment, but the clinical significance of these changes is unclear. These data are preliminary, and larger, controlled trials are needed to confirm whether antidepressants are detrimental to bone metabolism.

Several authors reveal financial ties to the pharmaceutical and biotech industries.

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