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Opioids, selective serotonin reuptake inhibitors (SSRIs), antipsychotics and, possibly, tricyclic antidepressants may increase the risk of hip fracture in elderly people, Pharmacoepidemiology and Drug Safety reports.

An Australian study included 8,828 people over 65 years of age who were hospitalised for hip fractures between 2009 and 2012. The median age was 88 years and 63 per cent were female.

Opioids increased hip fracture risk by 62 per cent, SSRIs by 54 per cent and antipsychotics by 47 per cent. The strength of the association with tricyclics depended on the statistical method used, varying from a non-significant 18 per cent increase to a significant 43 per cent rise.

The authors note that, “these psychoactive medicines may increase the risk of hip fracture in the short-term through central nervous system depression or hypotensive effects, which predispose patients to falls.”

They suggest that the risk “is potentially modifiable” by prescribing lower doses or alternative drugs and switching to other treatments, such as psychotherapy for mild-to-moderate depression. (DOI:10.1002/pds.3785).