Stopping antidepressants during pregnancy may lead to symptom ...( The women were provided with audiota...),Health

The women were provided with audiotapes outlining what was known about the risk of birth defects associated with antidepressants and about the possible risk that their depression could recur if medication was discontinued. They then made their own decisions whether to maintain or discontinue antidepressant medication during pregnancy. A total of 82 chose to maintain their medication dosage; 65 discontinued antidepressants; 34 decreased dosage and 20 increased dosage during their pregnancies. Out of all participants, 43 percent experienced relapse of depression symptoms during pregnancy, half during the first trimester. But while 68 percent of those who discontinued medication relapsed, only 26 percent of those who maintained their prepregnancy dosage had recurrence of symptoms.

"We know that women who become depressed during pregnancy may not take appropriate care of themselves or even make it to prenatal appointments, and there is evidence that maternal depression itself has an adverse effect on fetal and neonatal well being," says Cohen. "While this report does not offer explicit guidelines for individual patients, the study unequivocally suggests that women taking antidepressants who anticipate pregnancy need to address with their doctors not only potential risks to their babies if they continue taking the drugs but also the risk that their disease may recur if they stop antidepressants. Only by considering both sides of this risk/benefit equation can patients make informed decisions."

Members of the research team are currently analyzing additional data from these study participants to look for characteristics that may indicate who could safely discontinue treatment and who would be at risk for recurrence. They also are planning to examine the factors women used as a basis for deciding whether to continue medication as well as other information that could be helpful to patients and physicians.

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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
31-Jan-2006

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