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Randomised trial, 2017

Does adding birth control to antidepressants help depression that worsens before your period?

Adding drospirenone/ethinyl estradiol to antidepressants did not significantly improve premenstrual depression better than placebo in this small study. Both groups improved similarly.

Early or limited evidence Women with depression in remission on antidepressants who experience 30% worsening premenstrually (25 women completed)

What they did

Women with depression stable on antidepressants but experiencing 30% symptom worsening before their period were randomly assigned to add either a specific birth control pill (drospirenone/ethinyl estradiol) or placebo to their existing treatment. They took their assigned pill daily for 2 months and reported symptoms using depression scales tied to their menstrual cycle.

What they found

Of 32 women who started, 25 completed the study (12 on pill, 13 on placebo). Premenstrual depression scores fell 43.6% with the pill versus 38.9% with placebo (not statistically significant, p=0.59). A trend suggested women with fewer lifetime depressive episodes might benefit more.

What it means for you

This birth control pill added to antidepressants does not specifically help premenstrual depression beyond placebo. The study was very small with only 25 women and lasted just 2 months. Future research should test this approach in women confirmed to be hormone-sensitive.

25

women completed study

2 months

treatment duration

43.6%

depression improvement on pill

About the study

Original title
Treatment of Premenstrual Breakthrough of Depression With Adjunctive Oral Contraceptive Pills Compared With Placebo
Authors
Peters W, Freeman MP, Kim S et al.
Journal
Journal of clinical psychopharmacology
Year
2017
Study design
Randomised trial
Participants
13
What was tested
Drospirenone 3 mg/ethinyl estradiol 20 mcg added to antidepressants

Topics