During pregnancy, antidepressants are commonly discontinued to minimise the likelihood and impact of adverse outcomes associated with prenatal exposure to medications. This has been studied extensively, however the evidence for adverse pregnancy and child outcomes associated with relapse and untreated depression following medication discontinuation is insufficient. This has been explored by researchers in Canada, who conducted a systematic review and meta-analysis of studies involving women who discontinued antidepressants either 3 months prior to conception or during pregnancy. No significant difference in risk of relapse depression was found between women who discontinued or continued antidepressants during pregnancy. When the severity and recurrence of depression was considered during sub-analysis, risk of relapse was greater among populations with higher occurrence of severe or recurrent depression (risk ratio 2.30, 95% CI 1.58 – 3.35). The risks associated with both relapse depression and prenatal exposure to antidepressants should be discussed with women with severe or recurrent depression, and these people should be monitored during pregnancy if medication is stopped. The original article, published in the Journal of Clinical Psychiatry, can be viewed here.
Contributed by Isabella Singh, Australian Medication Safety Services Associate.