The selective serotonin reuptake inhibitor escitalopram oxalate negatively impacts the fracture healing in healthy adults and in osteoporotic rats

Escitalopram oxalate is a widely used drug for treating depressive conditions in various age groups. However, it exerts systemic side effects beyond its primary action in the brain, including impacts on bone, with negative repercussions on bone quality. Yet, the influence of this drug on fracture healing has not been investigated, and this is the focus of the present study. Fractures were created in the right femur diaphysis in healthy adult rats and those with osteopenia induced by prior ovariectomy. All animals underwent right femur fracture, and the subsequent healing process was examined. Four groups were established: Healthy Adult Sham, Osteoporosis Sham, Healthy Adult Escitalopram, and Osteoporosis Escitalopram. Oral administration of escitalopram was conducted daily via gavage for 35 days, while sham treatment consisted of distilled water administration via gavage. The bone callus analysis included the determination of bone mineral density, Computed microtomography images, mechanical resistance testing, and histomorphometry. Exposure to escitalopram resulted in the disruption of the bone callus, characterized by a decrease in trabecular thickness, an increase in trabecular separation, and greater deposition of type I collagen. Bone mineral density and strength, however, remained unaffected. In conclusion, escitalopram oxalate negatively interfered with fracture repair in both healthy and osteopenic rat bones.