Psychotropics and Hormonal Contraceptives: Are Drug Interactions a Cause for Concern?

A limited amount of data prompted the authors to call for more research
A limited amount of data prompted the authors to call for more research

A new study has deemed that concern for clinically significant drug interactions between hormonal contraceptives (HC) and psychotropic drugs is low; however, the authors of the study did assert that more research is needed in this area.

Researchers from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) collected 22 articles (18 studies) from PubMed and Cochrane libraries which met their criteria of co-administration of any HC with a number of different psychotropic treatments (selective serotonin reuptake inhibitors [SSRIs], tricyclic antidepressants [TCAs], bupropion, atypical antipsychotics, benzodiazepines); data on concomitant serotonin-norepinephrine reuptake inhibitors [SNRIs], mirtazepine, trazodone, hydroxyzine, buspirone, or MAOIs was not available and therefore not included in this study. 

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They found that there was no change in unintended pregnancy rates when HCs were administered with and without psychotropic drugs. Additionally, there was no significant change in psychotropic treatment outcomes when drugs were administered with and without HCs.

Contraceptive safety, contraceptive effectiveness and psychotropic drug effectiveness for most classes of psychotropic drugs did not display any change in drug exposure.

The TCAs amitriptyline and imipramine did raise concern with the authors, since limited data showed HCs may increase systemic exposure of these two agents.

Although the concern for significant interactions between HCs and psychotropics is low, the authors pointed out that the quality and quantity of evidence is limited; with just 22 articles meeting their criteria. Furthermore, for non-oral HC formulations, they found that no psychotropic comparison data exists.

The authors conclude by calling for further research to be conducted in this area, “given the high frequency of use for both HCs and psychotropic drugs among reproductive age women in the U.S.”

For more information visit PubMed.gov.

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