PregnancyAD · Antidepressant discontinuation during pregnancy and relapse risk in the perinatal period
Horizon 2020 — Marie Skłodowska-Curie Actions
- Duration
- 2021-05-01 → 2023-04-30
- EU contribution
- €201,393
- Participants
- 2
- Scheme
- MSCA-IF
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Results in brief
Antidepressant discontinuation during pregnancy and relapse risk in the perinatal period
Antidepressants are commonly used to treat affective disorders, and even pregnant women may receive antidepressants. However, concerns have been raised about the potential effects on the unborn children. As a result, more than half of pregnant women stop taking antidepressants. However, untreated or not adequately treated mental disorders during pregnancy can negatively impact the mother's and child's health. Therefore, expectant mothers face a difficult decision when using antidepressants while balancing their well-being with their unborn children. Although the effectiveness of psychiatric medications has been established in the general population, there is limited research on the efficacy of antidepressant treatment during pregnancy. Currently, no personalized recommendations are available to determine who can safely reduce or discontinue their antidepressant use without risking a relapse. This lack of guidance makes it crucial from a clinical standpoint to provide evidence-based information to assist in making treatment decisions tailored to individual needs, aiming to minimize unnecessary exposure while maintaining remission. The main objective of my research, supported by the MSCA fellowship, was to investigate the risk of relapse during the perinatal period following the discontinuation of antidepressants during pregnancy. To achieve this, I conducted several cohort studies by analyzing data from Danish national registers and genetic information. My findings indicate that continuing antidepressant treatment during pregnancy is associated with a reduced risk of relapse and has limited or no adverse effects on unborn children. Women who stop taking antidepressants late in pregnancy face a higher risk of relapse. These findings contribute to the limited evidence available regarding the effectiveness of antidepressant treatment during pregnancy, and they aim to support decision-making regarding antidepressant use in pregnant women.
Data: CORDIS, © European Union
Project objective
Antidepressants are the mainstay of pharmacological treatment for depressive and anxiety disorders in the perinatal period, and up to one in ten pregnant women take them. Among these women, over 50% discontinue antidepressants during pregnancy due to fear of possible adverse fetal effects. However, discontinuation may increase the risk of relapse, which can also have profound negative impacts. Evidence on perinatal relapse risk following antidepressant discontinuation during pregnancy is sparse and limited to highly selected populations. Moreover, the only factors considered in studies so far have been simple demographics and clinical features, while genetic profiling is conspicuously absent. The project aims to address knowledge gaps which urgently need to be understood in order for clinical care to provide personalized antidepressant treatment recommendations around pregnancy. This overarching objective will identify women at low or high relapse risk after discontinuing antidepressants during pregnancy and determine risk factors of relapse to enable personal risk estimates for the first time, in a large representative population, combining demographics, clinical features and genetic data retrieved from Danish national registers and the Integrative Psychiatric Research (iPSYCH) cohort. The project will provide a unique opportunity due to its multidisciplinary nature and innovative combinations of genetics and epidemiology. The proposed research will benefit from the expertise in genetics, genomics, and psychiatric epidemiology of the supervisors, and the fellow’s multidisciplinary skills in epidemiology and biostatistics applied on large, highly complicated datasets. The fellow will acquire state-of-the-art skills in the analysis of genetic data, planning, and management by training-through-research along with coursework. This project will form a fundamental leap towards her future independent career as a leading and international recognized epidemiologist.
Original text from CORDIS.
Participants
Links
- View on CORDIS
- DOI: 10.3030/891079
- https://www.researchgate.net/project/Antidepressant-discontinuation-during-pregnancy-and-relapse-risk-in-the-perinatal-period
Data: CORDIS, © European Union