Pregnant Women should Keep Taking Antidepressants to Avoid Relapse of Depression - Pregnancy Hormones Don't Protect - Study

January 31st 2006

Yoga during Pregnant

Women who stop taking antidepressants during pregnancy are five times more likely to have relapse of depression than women who continue the medication throughout their pregnancy. According to Lee Cohen, MD, director of the Perinatal and Reproductive Clinical Research Program at Massachusetts General Hospital (MGH), who led the investigation “Clinical lore has held for decades that pregnancy protected women from mood disorders.”

The findings from the first systematic clinical study of depression relapse runs counter to the long held belief that hormonal changes can prevent psychiatric problems. Dr. Cohen said "What drove this study was a divergence between that belief and what many of us were seeing clinically, that many women who stopped using antidepressants during pregnancy appeared to be relapsing."

According to the MGH press release, many published studies have supported the safety of antidepressant drugs taken while pregnant. There have been some reports of prenatal exposure to the popular selective serotonin reuptake inhibitors (SSRIs). These exposures could cause transient agitation or distress in newborns, according to MGH.

Recently there have been unpublished reports suggesting a potentially increased risk of cardiovascular defects in infants exposed to the SSRI paroxetine. The MGH study was intended to evaluate the risk of recurrent depression in pregnant women who chose to continue or to stop antidepressants during pregnancy.

The MGH study enrolled 201 women treated at the women’s mental health centers at MGH, the University of California Los Angeles (UCLA) and the Emory University School of Medicine. These participants were less than 16 weeks pregnant when entering the study and had a history of depression. Each had been successfully treated for depression with antidepressant medications for at least three months prior to becoming pregnant.

Out of the 201 participants, 82 chose to maintain their medication dosage, 65 quit their medication, 34 decreased their dosage and 20 increased their dosage during their pregnancies. There were 43 relapses of depression with half of them occurring during their first trimester.

The researchers compared the groups. Their results were as follows: 68 percent of the women who discontinued their medications relapsed, while 26 percent of the women who maintained their pre-pregnancy dosage had a “recurrence of symptoms”.

Dr. Cohen said "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."

The researchers are analyzing the data in a hope to determine the characteristics that may point to a decision on who can discontinue the antidepressants and who will have relapses if they do discontinue. There are risks either way, and it may help women make an informed decision.

New Study: Depression Drugs given to Pregnant Mothers May Affect Newborn Babies – Infants Withdraw From SSRIs