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In Young Women With ADHD, Higher Risk of Depression Linked With Oral Hormonal Contraceptive Use
Young women and girls with attention-deficit/hyperactivity disorder (ADHD) taking oral combined hormonal contraception (HC) have a 6 times higher risk of depression than those without ADHD taking oral combined HC, according to a recent cohort study. Additionally, in line with previous research, women with ADHD are at 3-fold higher risk for developing depression regardless of HC use compared with non-ADHD women.
Researchers from Uppsala University, Uppsala, Sweden, and Karolinska Institutet, Stockholm, Sweden, published their findings in the Journal of the American Academy of Child & Adolescent Psychiatry.
Using Swedish national registers, researchers analyzed data of girls and young women aged 15 to 24 years with ADHD (n=29,767, 3.8%) and without ADHD (n=763,146, 88.7%) who were used to provide measures of ADHD and depression diagnoses alongside the prescription of HC, stimulants, and antidepressant medication.
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Throughout the study, 41.9% of women and girls with ADHD developed depression or were prescribed antidepressants during the study period, compared with only 10.5% of the non-ADHD group. Women and girls using combined hormonal contraceptives (COC) had a 5 times higher risk of depression than a young woman without ADHD who is not using COC.
The risk of developing depression when using non-oral HC was similar in both groups and moderately increased. However, there was a significant interaction between ADHD diagnosis and any HC use on the risk of developing depression. Researchers suggest that ADHD is an effect modifier on that relationship.
Reasons why young women with ADHD respond differently to oral combined HC are unclear, and more research is needed. Still, study authors speculate it may be due to fluctuating hormonal levels from taking the pill versus the stable serum concentrations of the non-oral products. “There is a considerable lack of studies on how women with ADHD respond to hormonal fluctuations, but there are several reports on how progesterone fluctuations affect mood in women,” study authors wrote.
“Core symptoms of ADHD such as impaired cognitive function (ie, distractibility, disorganization, and impulsivity), as well as common comorbidity, may compromise consistent or correct use of ADHD medication and, potentially, adherence to contraceptive use,” authors concluded.
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