ORAL-CONTRACEPTIVES AND DEPRESSIVE SYMPTOMATOLOGY - BIOLOGIC MECHANISMS

Depression is an important but often overlooked side effect of oral contraceptives (OC). Depressive symptoms have been reported in up to 50% of women using contraceptive steroids.1 Although oral contraceptives exert their primary mode of action in the central nervous system, psychological sequelae have received less attention than other systemic side effects (e.g., hypertension, thromboembolic phenomena hepatomas, etc.). This paper elucidates some potential biologic mechanisms by which the oral contraceptives act on the central nervous system (CNS) to cause depression. The effect of these agents on biogenic amines (serotonin, dopamine, and norepinephrine), and on vitamin (folic acid, B6, B12), and endocrine metabolism are described. A better understanding of how oral contraceptives might cause depressive side effects should improve both our treatment for these problems and our understanding of brain biology. © 1979.