Depressive Symptoms and Oral Contraceptives

Herzberg, Brenda; Johnson, Anthony L.; Brown, Susannah

doi:10.1136/bmj.4.5728.142

Cited by 96 publications

(8 citation statements)

References 16 publications

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“…Studies that have examined the effects of these hormone treatments on mood have predominantly been conducted in populations of women with Premenstrual Dysphoric Disorder (PMDD) or healthy women. Early studies using oral contraceptives with high progestin doses reported depression as a possible side effect in normal women in case series and small case-control studies (Nilson and Almgren, 1968;Herzberg et al, 1970;Worsley and Chang, 1978). A large epidemiological-based study found that among women with PMDD who were starting hormone-based contraceptives, most women showed no change in mood, with mood improving in some women and worsening in others (Joffee et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression

Young

Kornstein

Harvey³

et al. 2007

Psychoneuroendocrinology

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SummaryObjective-Hormone-based contraceptives affect mood in healthy women or in women with Premenstrual Dysphoric Disorder. No study has yet examined their association with mood in women with major depressive disorder (MDD). The purpose of this study was to determine whether estrogenprogestin combination or progestin-only contraceptives are associated with depression severity, function and quality of life, or general medical or psychiatric comorbidity in women with MDD.Methods-This analysis focused on a large population of female outpatients less than 40 years of age with non-psychotic MDD who were treated in 18 primary and 23 psychiatric care settings across the United States, using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Baseline demographic and clinical information was gathered and compared Corresponding Author: Elizabeth A Young, MBNI, 205 Zina Pitcher place, Ann Arbor MI, 48109-0720, 1-734-936-2087 (Phone), 1-734-647-4130 (fax), eayoung@umich.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptPsychoneuroendocrinology. Author manuscript; available in PMC 2008 August 1. Published in final edited form as:Psychoneuroendocrinology. 2007 August ; 32(7): 843-853. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript between three groups based on hormonal use: combination (estrogen-progestin)(N=232), progestinonly (N=58), and no hormone treatment (N=948).Results-Caucasians were significantly more likely to use combined hormone contraception. Women on progestin-only had significantly more general medical comorbidities; greater hypersomnia, weight gain and gastrointestinal symptoms; and worse physical functioning than women in either of the other groups. Those on combined hormone contraception were significantly less depressed than those with no hormone treatment by the 16-item Quick Inventory of Depressive Symptomatology -Self-Rated. The combined hormone group also demonstrated better physical functioning and less obsessive-compulsive disorder comorbidity than either of the other groups.Conclusions-Synthetic estrogen and progestins may influence depressive and physical symptoms in depressed women.

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Section: Introductionmentioning

confidence: 99%

Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression

Young

Kornstein

Harvey³

et al. 2007

Psychoneuroendocrinology

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“…This suggestion is based on the findings that estrogen supplements in birth control pills may induce depressive states (Herzberg et al 1970) and that younger adults and adolescents, who presumably have higher sex hormone levels than older adults and prepubertal children, respond less favorably to antidepressants (Ryan et al 1986). However, these theories have not been substantiated with empirical data.…”

Section: Discussionmentioning

confidence: 97%

Evaluating Clinical Response of Open Nortriptyline Pharmacotherapy in Adolescent Major Depression

Ambrosini¹,

Bianchi²,

Metz³

et al. 1994

Journal of Child and Adolescent Psychopharmacology

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Adolescents with major depressive disorder (N = 25) were treated with nortriptyline 100 mg for 6 to 10 weeks. Clinical change was assessed by three treatment outcome measures: the Schedule for Affective Disorders and Schizophrenia (K-SADS-III-R) (to assess syndromal recovery, i.e., no longer fulfilling diagnostic criteria for the disorder), the self-rated Beck Depression Inventory, and a clinician-rated 17-item Depression Scale (derived from the K-SADS-III-R). At 6 weeks, recovery rates for full response were 44% to 57%, for partial response were 26% to 32%, and for nonresponse were 12% to 28%. Better outcome was not associated with concurrent treatment (hospital or outpatient), endogenous or nonendogenous status, or pretreatment depression severity. A significantly greater number of full and partial responders had plasma nortriptyline levels in the adult range of 50-150 ng/ml. None of the response measures, when analyzed as continuous variables, were curvilinearly associated with plasma nortriptyline levels, a finding which does not support the therapeutic window hypothesis. The 17 adolescents who were treated for 10 weeks continued to improve on all three outcome measures (syndrome, p < 0.07; Beck, p < 0.05; 17-Item, p < 0.004) relative to their response at 6 weeks. By 10 weeks, all three measures suggested clinical improvement, but no conclusions about efficacy can be offered in view of the open-label design, absence of placebo controls, diagnostic subtype heterogeneity, small sample size, and concurrent treatments.These data suggest that apparent improvement in adolescent major depressive disorder may vary, depending on treatment outcome criteria, plasma nortriptyline level, and treatment duration. Clinical recovery appears more rapid when treatment response is defined by the clinician-rating (17-Item Depression Scale) and slower when defined by self-rating (Beck Depression Inventory) or by diagnostic status (syndromal criteria). The clinician-rated scale may be more sensitive to early improvements in adolescents, as in adults. Extending treatment from 6 to 10 weeks increased the response rate by about 50%, so a 10-week trial of nortriptyline might be clinically indicated before nonresponse status in adolescents is established.

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“…While some studies have shown emotional disturbances associated with hormonal contraception use, others have shown no effect or even a beneficial effect of hormonal contraception use. 29,[60][61][62][63][64] DMPA use, though, has more consistently been shown to increase risk of depression. While a retrospective study that evaluated DMPA and risk of postpartum depression found no effect, a randomized trial of a long-acting injectable progestin demonstrated increased risk of postpartum depression.…”

Section: Discussionmentioning

confidence: 99%

Hormonal Contraception and Risk of Psychiatric and Other Noncommunicable Diseases in HIV-Infected Women

Castilho

Jenkins

Shepherd

et al. 2015

Journal of Women's Health

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Depressive Symptoms and Oral Contraceptives

Cited by 96 publications

References 16 publications

Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression

Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression

Evaluating Clinical Response of Open Nortriptyline Pharmacotherapy in Adolescent Major Depression

Hormonal Contraception and Risk of Psychiatric and Other Noncommunicable Diseases in HIV-Infected Women

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