Can Ethinylestradiol (Ethinyloestradiol)/Cyproterone acetate precipitate depersonalization disorder?

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From the Guidelines

Ethinylestradiol/Cyproterone can potentially precipitate depersonalization in some individuals, and its use should be carefully considered, especially in those with a history of neuropsychiatric conditions. The exact mechanism by which Ethinylestradiol/Cyproterone may contribute to depersonalization is not fully understood, but it is thought to be related to the hormonal effects of the medication on neurotransmitter systems in the brain, including serotonin and dopamine 1.

Key Considerations

  • The medication is typically prescribed for conditions like polycystic ovary syndrome, hirsutism, or as a contraceptive with anti-androgenic properties.
  • Individuals with a history of mood disorders, anxiety, or previous dissociative experiences may be at higher risk of experiencing depersonalization while taking Ethinylestradiol/Cyproterone.
  • The risks associated with Ethinylestradiol/Cyproterone, including venous thromboembolic events and cardiovascular risks, must be weighed against the potential benefits of the medication 1.

Recommendations

  • If symptoms of depersonalization occur while taking Ethinylestradiol/Cyproterone, such as feeling detached from oneself or surroundings, it is crucial to contact a healthcare provider promptly rather than discontinuing the medication abruptly.
  • Healthcare providers may recommend gradually tapering the medication and exploring alternative treatments depending on the individual's specific medical needs and the severity of their symptoms.
  • Regular monitoring for neuropsychiatric effects, including depersonalization, is essential for individuals taking Ethinylestradiol/Cyproterone, particularly those with a history of mood disorders or dissociative experiences 1.

From the Research

Ethinylestradiol/Cyproterone and Depersonalization

  • There is no direct evidence in the provided studies that suggests Ethinylestradiol/Cyproterone can precipitate depersonalization 2, 3, 4, 5, 6.
  • The studies focus on the use of Cyproterone acetate and Ethinylestradiol in treating conditions such as polycystic ovary syndrome, acne, and hirsutism, but do not mention depersonalization as a potential side effect 3, 5, 6.
  • Depersonalization disorder is discussed in studies 2 and 4, but these studies do not mention Ethinylestradiol/Cyproterone as a potential trigger for the condition.
  • The potential precipitants of depersonalization disorder mentioned in the studies include severe stress, depression, panic, marijuana and hallucinogen ingestion, and childhood interpersonal trauma 2.
  • Treatment options for depersonalization disorder are discussed in studies 2 and 4, but these do not include Ethinylestradiol/Cyproterone 2, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Use of cyproterone acetate/ethinylestradiol in polycystic ovary syndrome: rationale and practical aspects.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2017

Research

Depersonalization disorder: pharmacological approaches.

Expert review of neurotherapeutics, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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