Clomipramine and oral contraceptives: an interaction study--clinical findings

Forty-six depressed females were admitted to a study primarily designed to investigate the steady-state plasma levels of clomipramine and desmethyl-clomipramine in two groups of patients--one taking oral contraceptives, and one not. Twenty-one patients were taking oral contraceptives and twenty-five were not. Six 'pill'-takers dropped out of the study, two for drug-related reasons, and five non-'pill'-takers, two of whom also developed side-effects. Oral contraceptive takers were found to be significantly more depressed initially than controls, overall. Moreover, when the control group was examined in detail it was found to contain two sub-groups--one moderately depressed and one severely depressed. This latter sub-group was similar to the 'pill'-taking group. Both groups of patients improved similarly. There was no difference in the side-effects experienced. Clinically the study did not suggest that taking oral contraceptives had any influence on the effects of antidepressant medication. It did, however, suggest that either oral contraceptives cause depressed mood and loss of libido or, more likely, that when oral contraceptive takers become depressed these two factors interact to particularly influence mood and libidinous desire.