Continuing to take antidepressants during pregnancy was associated with higher rates of depressive relapses, hospitalizations and self-harming than stopping antidepressants, according to a study in Pharmacoepidemiology and Drug Safety.
“The decision whether to continue antidepressant use for depression during pregnancy requires weighing maternal and child risks and benefits,” stated the authors in their abstract. “Little is known about the effectiveness of antidepressant therapy during pregnancy.”
Led by Harvard School of Public Health researchers, the authors examined Medicaid claims between 2000 and 2007 for 28,493 women with a depression diagnosis who were taking antidepressants within 90 days before their last menstrual period, and then compared the women who stopped taking antidepressants with those who continued on the drugs.
Compared to the women who stopped taking antidepressants, the women who continued on the drugs were twice as likely to have a depression-related hospitalization, and 1.4 times as likely to have a recorded instance of deliberate self-harm. The results largely held even when accounting for other factors such as levels of baseline depression severity.
“Later in pregnancy, the number of women with an inpatient stay with a depression diagnosis was 2077 (8.6%) and 743 (16.9%) for those who discontinued versus continued AD (antidepressant) treatment, respectively; 237 (1.0%) and 91 (2.1%) had two or more inpatient stays,” they wrote. “Among the high-risk subgroup, 305 (15.0%) and 106 (26.2%) of women who discontinued versus continued AD treatment had at least one inpatient stay with a depression diagnosis; 71 (3.5%) and 25 (6.2%) had two or more stays.”
The authors concluded, “Our findings suggest that either antidepressant medications do not reduce the risk of depression relapse in pregnant women, or that administrative data alone could not be used to validly estimate the effectiveness of psychotropic medications during pregnancy.”
Swanson, Sonja A., Sonia Hernandez-Diaz, Kristin Palmsten, Helen Mogun, Mark Olfson, and Krista F. Huybrechts. “Methodological Considerations in Assessing the Effectiveness of Antidepressant Medication Continuation during Pregnancy Using Administrative Data†.” Pharmacoepidemiology and Drug Safety, June 1, 2015, n/a – n/a. doi:10.1002/pds.3798. (Abstract)