A recent cohort study that analyzed antidepressant use among women before, during, and after pregnancy, revealed significant declines in medication use during pregnancy without corresponding increases in psychotherapy claims.

Data from the MarketScan Research Databases found a significant reduction in antidepressant prescriptions during pregnancy—dropping from 4.3% before pregnancy to 2.2% during pregnancy—a 48.8% decrease.

The study followed 385,731 women who gave birth between 2011 and 2017. The data revealed that many women chose to avoid antidepressants during pregnancy due to safety concerns. However, "Women did not appear to substitute with psychotherapy; during pregnancy, we found a slight decrease in psychotherapy claims relative to a trend line," said lead author Claire Boone, PhD., of the Department of Economics, McGill University, Montreal, Quebec, Canada.

Study results showed that within 1 month after giving birth, women’s antidepressant use returned to pre-pregnancy levels, suggesting a swift resumption of treatment. Researchers noted the risks associated with untreated maternal depression, which can have long-term consequences for both mother and child, researchers noted study results published in JAMA Network Open.

Reliance on prescription refills, rather than measuring medication adherence, presented limitations. The absence of survey data to explore why women chose to discontinue medication also leaves questions unanswered. The sample was limited to women with private insurance, potentially limiting its broader applicability. Clinicians are urged to carefully discuss treatment options with pregnant women, especially given the high risks associated with maternal depression.

The authors disclosed no conflicts of interest.