title: Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: a nationwide population-based study with age-specific analyses.
abstract: OBJECTIVE
  To examine, among young women, the association of individual hormonal contraceptives, within two broad groupings, with antidepressant therapy.
  
  
  METHODS
  In a nationwide register-based study, we examined the prescription rates of antidepressant drugs in relation to individual combined hormonal and progestin-only contraceptives among Swedish women aged 16-31 years (N = 917,993). Drug data were obtained from the Swedish Prescribed Drug Register for the period 1 July 2005-30 June 2008. Data on the total population of women aged 16-31 in 2008 were obtained from the Total Population Register of Statistics Sweden. The proportion of women using both hormonal contraception and antidepressants, and odds ratios (ORs) for antidepressant use for hormonal contraceptive users versus non-users, were calculated, the latter by logistic regression, for each formulation.
  
  
  RESULTS
  The highest antidepressant OR in all age groups, particularly in the 16-19 years age group, related to medroxyprogesterone-only, followed by etonogestrel-only, levonorgestrel-only and ethinylestradiol/norelgestromin formulations. Oral contraceptives containing ethinylestradiol combined with lynestrenol or drospirenone had considerably higher ORs than other pills. ORs significantly lower than 1 were observed when ethinylestradiol was combined with norethisterone, levonorgestrel or desogestrel.
  
  
  CONCLUSIONS
  The association between use of hormonal contraceptives and antidepressant drugs varies considerably within both the combined hormonal contraceptive and the progestin-only groups.
authors.affiliation: Local Health Care Research and Development Unit, County Council in Östergötland, and Linköping University, Linköping, Sweden. malou.lindberg@lio.se
authors.forename: Malou
authors.initials: M
authors.lastname: Lindberg
authors.forename: Anniqa
authors.initials: A
authors.lastname: Foldemo
authors.forename: Ann
authors.initials: A
authors.lastname: Josefsson
authors.forename: Ann-Britt
authors.initials: AB
authors.lastname: Wiréhn
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects; D004338:Drug Combinations; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects; D016015:Logistic Models; D008234:Lynestrenol / Q000008:administration & dosage / Q000009:adverse effects; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000009:adverse effects; D009644:Norgestrel / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D016017:Odds Ratio; D010091:Oximes / Q000008:administration & dosage / Q000009:adverse effects; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D012042:Registries; D013548:Sweden
chemical_list: D000928:Antidepressive Agents; D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; D010091:Oximes; C044815:etonogestrel; D009644:Norgestrel; D016912:Levonorgestrel; D017135:Desogestrel; D008525:Medroxyprogesterone; D008234:Lynestrenol; C449219:norelgestromin