Continuing antidepressants in pregnancy improves post partum psychiatric outcomes

According to data from previous research, nearly one-half of women treated for affective disorders discontinue using antidepressants during pregnancy. This may lead to relapse postpartum. The question is, “Does longitudinal antidepressant fill trajectories during pregnancy and postpartum psychiatric outcomes?”

Considering this background, researchers did a cohort study including 41 475 live-born singleton pregnancies in Denmark (1997-2016) and 16 459 in Norway (2009-2018) for women filled at least one antidepressant prescription within six months before pregnancy. The women had mean maternal age of 30.7 and 29.9 years in Denmark and Norway, respectively. Within one year postpartum, psycholeptic initiation, psychiatric emergencies and self-harm record was the primary outcome measured.

The study points include the following:

• Among 57 934 pregnancies, four antidepressant fill trajectories were identified.
• The early discontinuers, late discontinuers previously stable, late discontinuers short-term users and continues in Norway and Denmark were 31.3% and 30.4%, 21.5% and 27.8%, 15.9% and 18.4% and 31.3% and 23.4% respectively.
• The probability of starting psycholeptics and postpartum psychiatric emergencies was lower among early and late discontinuers compared to the continuers.
• The late discontinuers (previously stable) compared to continuers had a moderately increased probability of starting psycholeptics having an HR of 1.13.
• The increase in late discontinuers (previously stable users) was higher among women with previous affective disorders having HR 1.28.
• The researchers reported no association between antidepressant fill trajectories and postpartum self-harm risk.

They said, “We reported moderately elevated probability of initiation of psycholeptics in late discontinuers (previously stable users) compared to continuers.”

Women with severe mental illness with a history of current table treatment benefit from continuing antidepressant treatment and personalized treatment counselling during pregnancy.

Further reading:

Guilbert A, Hough I, Seyve E, et al. Association of Prenatal and Postnatal Exposures to Warm or Cold Air Temperatures With Lung Function in Young Infants. JAMA Netw Open. 2023;6(3):e233376. doi:10.1001/jamanetworkopen.2023.3376