Levonorgestrel-containing IUDs: psychiatric adverse events

Levonorgestrel-containing IUDs: psychiatric adverse events Reactions 1704, p9 - 2 Jun 2018 Levonorgestrel-containing IUDs: psychiatric adverse events According to study results reported in Drug Safety, there is an association "consistent with a causal effect" between levonorgestrel-containing IUDs (LNG-IUDs) and anxiety or sleep problems; no significant associations were found with panic attacks or restlessness. The cohort study used data from the UK’s THIN general practice database in 2000–2016 to investigate the incidence of psychiatric adverse events in new users of non-hormonal IUDs (n=6871) or LNG-IUDs (n=10 872). Evaluation continued for up to 5 years from the start of treatment. The incidence of depression, a known outcome used as a positive control, was 22%. The incidence of anxiety was 13.5%, along with 6.8% for sleep problems, 1.4% for panic attacks, and 0.3% for restlessness. In patients without a prior history of psychiatric disorders, there was a significantly higher risk in LNG- IUD users compared with non-hormonal IUD users of depression (adjusted hazard ratio [HR] 1.17; 95% CI 1.08, 1.26), anxiety (HR 1.18; 1.08, 1.29) and sleep problems (HR 1.22; 1.08, 1.38). The risk was not significantly increased for panic attacks (HR 1.01; 0.79, 1.30) or restlessness (HR 0.95; 0.53, 1.72), although the authors note that the much lower frequency of these outcomes "mean that power was lacking to investigate these outcomes". Results followed a similar pattern for patients with a prior history of psychiatric disorders, but the differences were not statistically significant. "Substantive differences in baseline characteristics of the treated groups make robust conclusions difficult" note the authors, particularly gynaecological conditions like menorrhagia, "but the results strongly suggest that additional studies are warranted". Slattery J, et al. Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice. Drug Safety : 21 May 2018. Available from: URL: https://doi.org/10.1007/ s40264-018-0683-x 803323502 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Levonorgestrel-containing IUDs: psychiatric adverse events

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46652-7
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p9 - 2 Jun 2018 Levonorgestrel-containing IUDs: psychiatric adverse events According to study results reported in Drug Safety, there is an association "consistent with a causal effect" between levonorgestrel-containing IUDs (LNG-IUDs) and anxiety or sleep problems; no significant associations were found with panic attacks or restlessness. The cohort study used data from the UK’s THIN general practice database in 2000–2016 to investigate the incidence of psychiatric adverse events in new users of non-hormonal IUDs (n=6871) or LNG-IUDs (n=10 872). Evaluation continued for up to 5 years from the start of treatment. The incidence of depression, a known outcome used as a positive control, was 22%. The incidence of anxiety was 13.5%, along with 6.8% for sleep problems, 1.4% for panic attacks, and 0.3% for restlessness. In patients without a prior history of psychiatric disorders, there was a significantly higher risk in LNG- IUD users compared with non-hormonal IUD users of depression (adjusted hazard ratio [HR] 1.17; 95% CI 1.08, 1.26), anxiety (HR 1.18; 1.08, 1.29) and sleep problems (HR 1.22; 1.08, 1.38). The risk was not significantly increased for panic attacks (HR 1.01; 0.79, 1.30) or restlessness (HR 0.95; 0.53, 1.72), although the authors note that the much lower frequency of these outcomes "mean that power was lacking to investigate these outcomes". Results followed a similar pattern for patients with a prior history of psychiatric disorders, but the differences were not statistically significant. "Substantive differences in baseline characteristics of the treated groups make robust conclusions difficult" note the authors, particularly gynaecological conditions like menorrhagia, "but the results strongly suggest that additional studies are warranted". Slattery J, et al. Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice. Drug Safety : 21 May 2018. Available from: URL: https://doi.org/10.1007/ s40264-018-0683-x 803323502 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

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