Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors: Impact on trabecular bone score and bone mineral density in primary fibromyalgia

Background: Fibromyalgia is a chronic musculoskeletal pain disorder characterized by widespread pain at multiple tender points, sleep disturbance and fatigue, which subsequently affect quality of life.The aim of our study is to determine the correlation between consumption of SSRIs and SNRIs in patients with primary fibromyalgia, and BMD and TBS. Methods and Findings: A cross-sectional study carried out on 150 Egyptian participants. Patients were divided into 2 main groups: treatment group including 100 patients (50 on SSRI, and 50 on SNRI) diagnosed with primary myelofibrosis, and control group including 50 age-matched subjects (25 healthy individual, and 25 with primary myelofibrosis but receiving medications other than SSRI and SNRI).BMD and TBS were significantly low in SSRI and SNRI treatment groups compared to healthy control. In older population, lumbar spine (L1-L4) BMD and TBS decreased significantly in SSRI group. Also, control patients with primary fibromyalgia showed low BMD. Conclusion: Our study showed that patients with primary myelofibrosis, especially old population, whose treatment involved SSRIs or SNRIs had low BMD and low TBS. Additionally, patients with primary fibromyalgia who neither received SSRI nor SNRI also experienced low BMD. Thus, primary myelofibrosis could be considered as a contributing factor for low BMD.