Nearly half of pregnant women prescribed selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors discontinue their use during pregnancy. However, a recent study found no increase in adverse psychiatric outcomes postpartum for these women compared with those who continued their medications.

This population-based cohort study examined psychiatric outcomes and sick leave among women who discontinued selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) during pregnancy. The study followed 27,773 Swedish women who had been prescribed these medications prior to pregnancy, and 47.5% of them stopped treatment. Among those who discontinued, 42.4% were under 30 years old, compared to 33.9% in the continued-use group. Additionally, 32.5% of those who discontinued had postsecondary education or higher, compared to 39.9% of the continued-use group.

The primary focus was whether discontinuation was linked to an increased prevalence of psychiatric outcomes in women without severe psychiatric conditions. Published in JAMA Network Open, the findings revealed no significant increase in adverse outcomes, such as hospitalizations, outpatient visits, suicidal behavior, or sick leave absence, within 90 days or up to 1.5 years postpartum. Psychiatric-related hospitalizations occurred in 0.4% of the discontinued group and 0.5% of the continued-use group. Adjusted hazard ratios (aHR) showed no increased risk, with an aHR of 1.28 (95% CI, 0.85-1.91) for hospitalizations within 90 days and 0.81 (95% CI, 0.66-1.00) at 1.5 years postpartum.

No significant differences in sick leave absence were observed between groups, though women who discontinued their medication had fewer sick leave days on average (44.6 days vs. 53.1 days in the continued group).

These findings suggest that discontinuing SSRIs or SNRIs during pregnancy is not associated with an increased risk of adverse psychiatric outcomes in women with mild to moderate depression or anxiety.

Full disclosures can be found in the published study.