Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Menopause. 2013 Feb;20(2):146-51. doi: 10.1097/gme.0b013e3182611590.
This work aims to determine whether discontinuation of hormone therapy (HT) in perimenopausal and postmenopausal women is associated with an increased risk of initiating antidepressant therapy.
A population-based cohort study was conducted using data from the Swedish Prescribed Drug Register and the Total Population Register for the period July 2005 to June 2009. We included women aged 45 to 70 years who had used HT continuously for more than 6 months before July 2008. Women with previous use of antidepressants since July 2005 were excluded. We compared the incidence rates of initiating antidepressant therapy during HT and after withdrawal of HT. The women were followed from July 2008 until the first dispensing of antidepressants, restart of HT, migration, death, or end of the study period, whichever occurred first. Poisson regression analysis was used to estimate the incidence rate ratios adjusting for potential confounders (age, calendar time, duration of HT use, and number of HT prescriptions).
Of the 101,911 women enrolled in the cohort, 39.8% discontinued HT during follow-up. Discontinuation of HT was associated with an increased risk of antidepressant use (incidence rate ratio, 1.24; 95% CI, 1.11-1.38). Women 65 years or older and women who had used HT for 3 years or more had the highest risk estimates, but effect modification by age and duration was not significant.
We found a slightly increased risk in the use of antidepressant therapy after discontinuation of HT.
本研究旨在确定绝经前期和绝经后妇女停止激素治疗（HT）是否与开始抗抑郁治疗的风险增加相关。
本研究采用基于人群的队列研究，数据来源于瑞典处方药物登记处和全人群登记处，研究对象为 2005 年 7 月至 2009 年 6 月期间年龄在 45 至 70 岁之间、连续使用 HT 超过 6 个月且在 2008 年 7 月之前未使用过抗抑郁药物的女性。我们比较了 HT 期间和停止 HT 后开始使用抗抑郁药物的发生率。从 2008 年 7 月开始对女性进行随访，直至首次开出抗抑郁药物、重新开始 HT、移民、死亡或研究结束，以先发生者为准。采用泊松回归分析，调整了潜在混杂因素（年龄、日历时间、HT 使用持续时间和 HT 处方数量）后，估计发病率比值比。
在纳入的 101911 名女性队列中，39.8%在随访期间停止了 HT。停止 HT 与抗抑郁药使用风险增加相关（发病率比值比，1.24；95%CI，1.11-1.38）。65 岁及以上的女性和使用 HT 3 年或以上的女性风险估计值最高，但年龄和持续时间的效应修饰不显著。
我们发现 HT 停止后使用抗抑郁药物治疗的风险略有增加。
