title: Initiating therapy with antidepressants after discontinuation of hormone therapy.
abstract: OBJECTIVE
  This work aims to determine whether discontinuation of hormone therapy (HT) in perimenopausal and postmenopausal women is associated with an increased risk of initiating antidepressant therapy.
  
  
  METHODS
  A population-based cohort study was conducted using data from the Swedish Prescribed Drug Register and the Total Population Register for the period July 2005 to June 2009. We included women aged 45 to 70 years who had used HT continuously for more than 6 months before July 2008. Women with previous use of antidepressants since July 2005 were excluded. We compared the incidence rates of initiating antidepressant therapy during HT and after withdrawal of HT. The women were followed from July 2008 until the first dispensing of antidepressants, restart of HT, migration, death, or end of the study period, whichever occurred first. Poisson regression analysis was used to estimate the incidence rate ratios adjusting for potential confounders (age, calendar time, duration of HT use, and number of HT prescriptions).
  
  
  RESULTS
  Of the 101,911 women enrolled in the cohort, 39.8% discontinued HT during follow-up. Discontinuation of HT was associated with an increased risk of antidepressant use (incidence rate ratio, 1.24; 95% CI, 1.11-1.38). Women 65 years or older and women who had used HT for 3 years or more had the highest risk estimates, but effect modification by age and duration was not significant.
  
  
  CONCLUSIONS
  We found a slightly increased risk in the use of antidepressant therapy after discontinuation of HT.
authors.affiliation: Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. anna.citarella@ki.se
authors.forename: Anna
authors.initials: A
authors.lastname: Citarella
authors.forename: Morten
authors.initials: M
authors.lastname: Andersen
authors.forename: Anders
authors.initials: A
authors.lastname: Sundström
authors.forename: Carola
authors.initials: C
authors.lastname: Bardage
authors.forename: Christina M
authors.initials: CM
authors.lastname: Hultman
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
mesh_terms: D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause; D017698:Postmenopause; D012042:Registries; D013375:Substance Withdrawal Syndrome / Q000523:psychology; D013548:Sweden
chemical_list: D000928:Antidepressive Agents