Raising levels of serotonin, by use of reuptake inhibitors or monoamine oxidase inhibitors, interferes with normal flexible homeostatic stress-coping mechanisms producing side effects and increasing the risk of suicide.[1-3]

In women, progesterone and progestogens used for contraception or hormone therapies cause depression by increasing monoamine oxidase (MAO) levels in the late secretory phase of a normal cycle or during medication.[4] The Royal College of General Practitioners oral contraceptive study found use increased “depressive neurosis” while suicide was the commonest cause of death in takers. Ever takers had higher rates of violent deaths than never takers.[5-7] In 2010, a study of a million Swedish women found progestin-only takers had increased risks of antidepressant use with the highest risk in new contraceptive hormone takers aged 16 to 19 years.[7]

Biogenic amine metabolism is impaired by very common deficiencies of zinc, magnesium, copper, B vitamins, essential fatty acids, and, by toxic DNA adducts such as cadmium from tobacco and nickel from stainless steel. How many psychiatrists analyse the cell chemistry of their patients?

1 Healy D. Serotonin and depression BMJ 2015;350:h1771 2 Grant ECG. The influence of hormones on headache and mood in women. Hemicrania 1975;6:2-10. 3 Grant ECG. Allergies smoking and the contraceptive pill .In Biological Aspects of Schizophrenia and Addiction.1982.Ed Hemmings G, John Wiley & Sons, Chichester pp263-72 4 Grant ECG, Pryce Davies J. Effect of oral contraceptives on depressive mood changes and on endometrial monoamine oxidase and phosphatases. BMJ 1968;3:777-80 5 Royal College of General Practitioners. Oral Contraceptives and Health. 1974 Pitman Medical, London. 6 Royal College of General Practitioners. Oral contraception study: some recent observations 1984;11 759-86. 7 Hannaford PC, Iversen L, Macfarlane TV, et al. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study. BMJ 2010; 340: c927 8 Wiréhn AB, Foldemo A, Josefsson A, Lindberg M. Use of hormonal contraceptives in relation to antidepressant therapy: A nationwide population-based study. Eur J Contracept Reprod Health Care 2010;15:41-7. 9 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity, and mineral imbalance. J Nutr Environ Med 1998;8:105-116 10 Grant ECG. Supplementing proven deficiencies of vitamins and minerals. Lancet 2006 Jul 29;368(9533):366.

Competing interests: No competing interests