Background Pharmacoepidemiological studies have demonstrated an excess risk of hip fractures attributable to the use of antidepressants. In a recent systematic review the pooled relative risk (RR) of hip fracture was 1.70 for antidepressant users, compared to non-users. The potential impact of the use of antidepressants on the rate of hip fracture in Hungary has not been studied before.

Purpose To quantify the possible relationship between antidepressant consumption and the excess risk of hip fracture in Hungary, based on the results of published studies and national drug use data in 2012. The population-attributable risk (PAR) of hip fracture associated with the use of antidepressants was evaluated. We also estimated the yearly cost of the operations after hip fractures related to antidepressant use.

Material and methods For most countries, the prevalence (Pe) of antidepressant use can only be estimated if Intercontinental Medical Statistics and freely available public databases (Denmark, the Netherlands, Norway) are used for data extraction. Pe in Hungary can be estimated using the following formula:

Estimated Pe_Hungary = [(Antidepressants DDDs/1,000 persons/day_Hungary)/(Antidepressants DDDs/1,000 persons/day_{Public databases})] × Pe_{Public databases.}

Pe and the pooled RR from the systematic review of published studies were combined with the following formula to calculate country-specific PAR%:

PAR% = [(Pe (RR − 1))/(1 + Pe (RR − 1))] × 100.

The cost of the operations after hip fractures was calculated using national data.

Results The Hungarian antidepressant consumption is 26.87 DDDs/1,000 persons/day. The estimated PAR of antidepressants on hip fracture rates in Hungary is 2.12% (95% CI, 1.44–2.95). The estimated PAR for the Hungarian population above 65 years is 3.86% (95% CI, 2.62–5.32).

The estimated yearly cost of the operations after hip fractures related to antidepressant use is 1.5–2.5 million Euros in Hungary.

Conclusion Our findings suggest that the potential contribution of antidepressant use to the population rate of hip fractures is 2.12% in Hungary, which may cause a significant social burden.

References and/or acknowledgements No conflict of interest.