Deterioration/relapse of depression during pregnancy in Japanese women associated with interruption of antidepressant medications

This study examined the risk of deterioration/relapse in pregnant women who discontinued their antidepressant medications based on the discretion of the psychiatric specialists compared with those who performed self-interruption. We reviewed the obstetric records of all singleton deliveries beyond 22 weeks of gestation at Japanese Red Cross Katsushika Maternity Hospital from January 2009 through December 2015. Compared with the women continuing antidepressant medications throughout pregnancy, the incidence of deterioration/relapse was higher in the women who discontinued their antidepressant medications regardless of who made the decision (interruption based on the discretion of the psychiatric specialists: 61%, odds ratio (OR), 8.05; 95% confidence interval (CI), 2.4-27; p<0.01; self-interruption: 63%, odds ratio (OR), 8.79; 95% confidence interval (CI), 2.6-29; p<0.01 versus 16%). The continuation of medications and careful observation are required for pregnant women complicated by depressive disorders.