OCs Could Lessen Premenstrual Worsening of Depression: Study


ATLANTA — The use of oral contraceptives appears to decrease the premenstrual worsening of depressive symptoms, Hadine Joffe, M.D., said at the annual meeting of the American Psychiatric Association.

In preliminary research, the use of augmentation with oral contraceptive pills was evaluated in women who already take antidepressants but experience worsening symptoms during the luteal phase of the menstrual cycle, said Dr. Joffe, a psychiatrist at Massachusetts General Hospital, Boston.

The 17 women who completed the study reduced their depression scores during the premenstrual phase on the Daily Record of Severity of Problems Scale from a median score of 58 to a median score of 35.3. In addition, their Montgomery-Asberg Depression Rating Scale scores improved from a median of 20 to a median of 4.

A total of 26 women, aged 18–45 years, were randomized to a double-blind treatment with an oral contraceptive containing drospirenone and ethinyl estradiol (Yasmin). One group received additional ethinyl estradiol on days 22–28, which is the typical placebo week of the oral contraceptive pills.

To be eligible for the 2-month study, women had to have regular 25- to 35-day menstrual cycles, a depressive disorder, and stable use of an antidepressant for 2 months or more. In addition, all participants completed a run-in tracking month before starting the oral contraceptive pill. Depressive symptoms were found to be present only during the premenstrual phase.

Of the women included in the study, 82% had major depression, 12% had minor depression, and 6% had dysthymia.

The oral contraceptive pills were well tolerated, and there appeared to be no difference between women who received the additional ethinyl estradiol during days 22–28 of their cycles and those who received placebo during that time.

The study was sponsored by the National Alliance for Research on Schizophrenia and Depression, and product support was provided by Berlex, which manufactures Yasmin.

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