Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors

J Comp Eff Res. 2016 Aug;5(5):461-73. doi: 10.2217/cer-2016-0009. Epub 2016 Jul 18.

Abstract

Aim: To evaluate comparative safety of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) for the risk of hip fractures.

Patients & methods: A propensity score-matched retrospective cohort study was conducted using 2007-2010 Minimum Data Set linked Medicare data. Robust Cox proportional hazards model was used to evaluate the risk of hip fractures in depressed elderly nursing home residents.

Results: Cox analysis did not find any significant difference in the risk of hip fractures for the paroxetine users (hazard ratio: 1.09; 95% CI: 0.91-1.32) when compared with other SSRIs. Results from the sensitivity analysis supported the main findings.

Conclusion: There was no differential risk of hip fractures between paroxetine and other SSRIs. Future studies are needed to evaluate other anticholinergic effects of paroxetine.

Keywords: Medicare; SSRIs; comparative effectiveness; comparative risk; depression; elderly; hip fracture; nursing home residents; paroxetine; selective serotonin reuptake inhibitors.

MeSH terms

  • Aged
  • Depression / drug therapy*
  • Female
  • Hip Fractures*
  • Humans
  • Male
  • Nursing Homes / statistics & numerical data
  • Paroxetine / therapeutic use*
  • Retrospective Studies
  • Risk
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*

Substances

  • Serotonin Uptake Inhibitors
  • Paroxetine