Antidepressant discontinuation worsens postpartum psychiatric outcomes: JAMA

The study identified four antidepressant fill trajectories: early discontinuers, late discontinuers (previously stable users), late discontinuers (short-term users), and continuers.

Early discontinuers and late discontinuers (short-term users) had a lower probability of initiating psycholeptics and having postpartum psychiatric emergencies compared to continuers. However, a moderately increased probability of initiation of psycholeptics was found among late discontinuers (previously stable users) compared to continuers.

This increase was more pronounced among women with previous affective disorders. No association between antidepressant fill trajectories and postpartum self-harm risk was found. However, the study's limitations include the lack of information on the specific antidepressants used and the possibility of unmeasured confounding factors. Overall, the study provides important insights into the management of affective disorders during pregnancy and postpartum.

Source: 

Trinh, N. T. H., Munk-Olsen, T., Wray, N. R., Bergink, V., Nordeng, H. M. E., Lupattelli, A., & Liu, X. (2023). Timing of Antidepressant Discontinuation During Pregnancy and Postpartum Psychiatric Outcomes in Denmark and Norway. In JAMA Psychiatry. American Medical Association (AMA). https://doi.org/10.1001/jamapsychiatry.2023.0041