Priority 16 from the Contraception PSP

UNCERTAINTY: Do progestogens used alone or in combined hormonal contraception interact with anti-depressants?  (JLA PSP Priority 16)
Overall ranking 16
JLA question ID 0049/16
Explanatory note Depression/anxiety affects about 1 in 7 women in the UK. The effects of hormonal contraception on mood in all was raised by many users and healthcare professionals,  this priority is the effect on a -women with on treatment  which is a specific group but which overlaps with the research priority 2 and the NICE LARC guideline research recommendations “Most women will need to use contraception for more than 30 years… a woman's choice and acceptance of LARC may be influenced by potential health dis-benefits (side effects and risks) as well as non contraceptive benefits of LARC.. The NATSAL3 survey DOI:,found  depression to be associated with a doubling of the risk of unplanned pregnancy. 

Association of Hormonal Contraception with Depression. Skovlund CW, Mørch LS, Kessing LV, et al .JAMA Psychiatry. 28 September 2016. doi:10.1001/jamapsychiatry.2016.2387

Drug interactions between hormonal contraceptives and psychotropic drugs: a systematic review. Erin N. Berry-Bibee, Myong-Jin Kim, Katharine B. Simmons, Naomi K. Tepper, Halley E.M. Riley, H. Pamela Pagano, Kathryn M. Curtis. Contraception, Vol. 94, Issue 6, p650–667. Published online: July 18, 2016. PreviewFull-Text HTMLPDF

Co-administration of St. John's wort and hormonal contraceptives: a systematic review. Erin N. Berry-Bibee, Myong-Jin Kim, Naomi K. Tepper, Halley E.M. Riley, Kathryn M. Curtis.  Contraception, Vol. 94, Issue 6, p668–677. Published online: July 18, 2016.

Pagano HP, Zapata LB, Berry-Bibee EN, et al. Safety of hormonal contraception and intrauterine devices among women with depressive and bipolar disorders: a systematic review. Contraception. 27 June 2016. pii: S0010-7824(16)30133-0. DOI: 

Health Research Classification System category Reproductive Health and Childbirth
Extra information provided by this PSP
Original uncertainty examples

“Contraception (all) side effects when taken with other medicines - in particular anti-depressants (flouexetine, citalopram)”(Both)


Submitted by Healthcare Professionals x 0~Patients x 0~Both x 2
PSP information
PSP unique ID 0049
PSP name Contraception
Total number of uncertainties identified by this PSP. 57  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 April 2017