Oral Contraceptives and Depression

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To the Editor: —I have discussed the following problem with my psychiatric colleagues, and they feel that this matter should be brought to the attention of physicians in general. The use of the mixture norethynodrel with mestranol (Enovid) and other oral contraceptives is becoming more and more widespread. The usual side effects—nausea, bloating, and withdrawal bleeding—are well known. A less common complaint of some patients is severe depression. Within the last year I have had three patients complain about this symptom. Two of them had been under psychiatric care for depressions prior to the use of the norethynodrel mixture. Both patients also found the same effect from an experimental mixture of norethisterone acetate and ethinyl estradiol (Norlestrin). Because of depression, both patients were unable to tolerate the medications, and therefore discontinued their use. The third patient was originally given the norethynodrel mixture, 5 mg, to control premenstrual headaches, dysmenorrhea, and

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