We read with much interest the original investigation by Richards et al.1 They indicate that daily SSRI use in adults 50 years and older was associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential covariates. These findings are very interesting, and, as the authors state, may have important public health consequences. However, some comments on this article can be made.
Ziere G, Dieleman JP, van der Cammen TJM, Stricker BHC. Association Between SSRI Use and Fractures and the Effect of Confounding by Indication. Arch Intern Med. 2007;167(21):2369-2370. doi:10.1001/archinte.167.21.2369-b