Section - Quick Takes

05. Use of Hormonal Contraceptives and Antidepressants and Risks of Suicidal Behavior and Accidents Among Women With Premenstrual Disorders: A Nationwide Cohort Study

Published on May 1, 2023 Expired on May 1, 2026

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

In previous work, this research group found an association between perimenstrual disorders and accidents and injuries as well as with suicidal behavior. Now they ask: Are these attenuated among women using oral contraceptives or antidepressants?
Using Sweden’s medical registry data for a sample of 1.5 million women, the answer: Accidents, injuries, no; suicidal behavior, yes.
Antidepressants were associated with an increase in suicidal behavior, but this is likely due to confounding by indication.

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This sounds fascinating even before glancing at the article. Just look at the title: Use of hormonal contraceptives and antidepressants and risks of suicidal behavior and accidents among women with premenstrual disorders. Then with the first line of the abstract, I’m further intrigued: “Women with premenstrual disorders are at increased risk of suicidal behavior and accidents.” Really? Accidents?

Hi! Jim Phelps here for the Psychopharmacology Institute. Let’s start with this accidents thing. The Institute of Environmental Medicine—a research group in Stockholm, Sweden—published a paper in 2021 which found women with PMS compared with those without such a diagnosis in their registry had a 32% increased risk for accidents, a 37% increased risk for injury and more than a doubled risk of suicidal behavior. In that study, Dr. Qian Yang and colleagues looked at 1.5 million women of reproductive age in Sweden in data from 2001–12. Of these, roughly 18,000 had

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Learning Objectives:

Evaluate the efficacy of haloperidol vs placebo for the management of delirium in intensive care units.
Examine the potential relationship between antidepressant use and gestational diabetes.
Evaluate the risk of cardiovascular events associated with medications for attention-deficit/hyperactivity disorder using data from 19 studies.
Examine research on the joint effects of early childhood adversity and cannabis use on white matter integrity.
Evaluate research on the associations between oral contraceptives, antidepressants, and the risks for suicidal behavior and accidents among patients with premenstrual disorders.

Original Release Date: May 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: May 1, 2026

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

James R Phelps declares the following interests:

- McGraw-Hill: Royalties

- W.W. Norton & Co.: Royalties

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

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