SSRIs and Depot Medroxyprogesterone Acetate (DMPA): No Clinically Significant Interaction

Evidence from the U.S. Medical Eligibility Criteria for Contraceptive Use

• The U.S. Medical Eligibility Criteria for Contraceptive Use does not list SSRIs or any antidepressants as having drug‑drug interactions with DMPA, indicating that co‑administration is considered safe without special precautions. 1
• Because SSRIs are absent from the comprehensive interaction list (which includes antiretrovirals, certain anticonvulsants, and antimicrobials), the criteria infer that no clinically relevant interaction exists between SSRIs and DMPA. 2

Interaction Context from SSRI Guidelines

• The American Urological Association (AUA) guideline on SSRIs notes potential pharmacokinetic interactions with drugs metabolized by cytochrome P450 enzymes, but explicitly excludes progestin‑only injectables such as DMPA from these concerns. 3

Practical Clinical Recommendations

• No dose adjustment of either the SSRI or DMPA is required when the two agents are prescribed together. 1
• No additional backup contraception is needed for patients initiating an SSRI while using DMPA. 2

Contraceptive Effectiveness While on SSRIs

• DMPA retains its high efficacy (≈ 0.2 % failure with perfect use and ≈ 6 % failure with typical use) regardless of concurrent SSRI therapy. 4

Standard DMPA Dosing Schedule

• The recommended regimen is 150 mg intramuscularly or 104 mg subcutaneously every 13 weeks, with a permissible grace period of up to 2 weeks (total interval ≤ 15 weeks). 5