Prescription of antidepressants is increased in Danish patients with polycystic ovary syndrome and is associated with hyperandrogenism. A population-based cohort study

Objective Quality of life is impaired in polycystic ovary syndrome (PCOS). In this study, we compared the time to first prescription of antidepressants (ADM) in PCOS vs two control groups. Design Register-based cohort study. Patients One thousand and one hundred and twenty-four premenopausal women with hirsutism and/or PCOS, premenopausal women with hypertension (HT, n = 301), and age- and sex-matched population controls (controls, n = 4110). Measurements Prescriptions for ADM on secondary care contacts from regional registers. Results The median age at cohort entry in PCOS, HT and controls was 29, 34 and 29 years, respectively. Among PCOS, HT and controls, 227 (20%), 74 (25%) and 633 (15%), respectively, had prescriptions of ADM. The median time to first prescription of ADM in the PCOS, HT and control cohorts was 6·8, 6·6 and 7·2 years, respectively. The adjusted hazard ratio for time to prescription of ADM for HT vs PCOS was 1·36 [95% CI (1·02-1·82)], P = 0·039, and for controls vs PCOS, it was 0·75 [95% CI (0·64-0·88)], P < 0·001. Within patients with PCOS, hyperandrogenism contributed significantly to the model, likelihood ratio test P = 0·009. The adjusted hazard ratio for hyperandrogenism vs no hyperandrogenism was 1·97 (1·12- 3·45), P = 0·018. Conclusion Patients with PCOS had moderately but significantly decreased time to first prescription of ADM compared with age-matched healthy women, whereas patients with HT had the shortest time to prescription. In PCOS, prescription of ADM was associated with the presence of hyperandrogenism.