Use of hormonal contraceptives, especially among adolescents, was associated with depression, a large Danish study has found.
The nationwide prospective study included all women and adolescents aged 15 to 34 years living in Denmark between 2000 and 2013 after excluding those with a prior diagnosis of depression or other major psychiatric disorder.
A total of 1,061,997 women, followed up for an average of 6.4 years, were included in the analysis.
The study, published in JAMA Psychiatry, found that the use of all types of hormonal contraceptive was positively associated with the subsequent use of antidepressants and a diagnosis of depression.
During the follow-up period, 55% of the women and adolescents were current or recent users of hormonal contraception. A total of 133,178 first prescriptions of antidepressants and 23,077 first diagnoses of depression at a psychiatric hospital were detected during follow-up.
The highest risk rates were seen among adolescent girls, aged 15 to 19 years, who had 1.8 times higher risk of first use of an antidepressant using combined oral contraceptives and 2.2 times higher risk with progestin only pills. The highest risk was seen among adolescent girls using non-oral products, who had a three times higher risk for first use of an antidepressant.
Compared with non-users, women who used combined oral contraceptives had 1.23 times higher relative risk of a first use of an antidepressant.
The study authors said that their findings fitted in with the theory that progesterone played an important role in the cause of depression.
The authors concluded: “Further studies are warranted to examine depression as a potential adverse effect of hormonal contraceptive use.”