Many women stop taking antidepressants during pregnancy but don’t substitute their depression management with psychotherapy, reports a study in JAMA Network Open.
“Choosing whether to continue taking antidepressants during pregnancy can be complicated,” wrote Claire Boone, Ph.D., of McGill University, and colleagues. “Although evidence is limited, there are safety concerns regarding in utero exposure to some antidepressant medications. However, untreated maternal depression can have severe long-term consequences for mother and child.”
The researchers used the Merative MarketScan Research Databases, which contain private insurance claims data, to analyze prescription trends in 385,731 women who gave birth between 2011 and 2017.
Overall, 4.3% of women in the sample filled an antidepressant prescription in the year before pregnancy while 2.2% filled a prescription during pregnancy. Within one month of childbirth, antidepressant prescriptions returned to pre-pregnancy trends. In addition, there was a slight decrease in psychotherapy claims among pregnant women compared with pre-pregnancy trends, with such claims also jumping back up after childbirth.
The researchers did not find similar drops in antidepressant use among the spouses of these women during pregnancy, suggesting that the medication change was not associated with other, co-occurring changes in the couple’s life.
These findings show that many women value treatment “but were choosing to avoid antidepressant use during pregnancy. However, given the time delay for antidepressant medication to function, restarting medication after pregnancy may leave many women effectively untreated during the high-risk postnatal period,” Boone and colleagues wrote.
For related information, see the Psychiatric News article “Mood Symptoms in Pregnant Women May Not Be Fully Resolved by SSRIs.”
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