Section - Quick Takes

04. The Risk of Relapse of Depression During Pregnancy After Discontinuation of Antidepressants: A Systematic Review and Meta-Analysis

Published on February 1, 2021 Expired on April 1, 2024

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

For women who stopped their antidepressants during pregnancy, relapse rates ranged from 15% to 68% in 6 studies. - The authors defined relapse as meeting DSM criteria for major depression or as any restart or increase in antidepressant dose. The last criteria confound relapse with antidepressant withdrawal, making the interpretation of this study difficult.

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Imagine what this means: Only 1 in 4 women who are on antidepressant treatment before conception is still taking an antidepressant in the third trimester. So, if 3 out of 4 women are stopping, what’s the relapse rate into major depression? If you’ve been following the controversy about the frequency of severe withdrawal symptoms during antidepressant discontinuation, you know that asking this question about relapse during pregnancy is going to take us right into that controversy and give us important information about the management of depression during pregnancy.

Hi! Jim Phelps here for the Psychopharmacology Institute. In this Quick Take, we’ll look at a review and meta-analysis by Hamideh Bayrampour and her colleagues at the University of British Columbia. First, I’ll present to you their results with just enough of the study design to evaluate their findings, and then I’ll add my own spin. Dr. Bayrampour and her colleagues screened

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05. Efficacy and Clinical Predictors of Response to rTMS Treatment in Pharmacoresistant Obsessive-Compulsive Disorder (OCD): A Retrospective Study

Learning Objectives:

After completing this activity, the learner will be able to:

Review the current understanding of Alzheimer's dementia risk and protective factors using a new meta-analysis, which rank-orders factors by relative risk.
Assess the evidence for claims of superior efficacy of selected antidepressants for the treatment of cognitive impairment in the context of major depressive disorder.
Review the evidence for treatment options for severe neuroleptic malignant syndrome.
Analyze a recent review and meta-analysis of depression relapse rates upon antidepressant discontinuation during pregnancy.
Assess the value of transcranial magnetic stimulation for patients with treatment-resistant obsessive-compulsive disorder.

Original Release Date: 02/01/2021

Review Date: 03/01/2024

Expiration Date: 04/01/2024

Relevant Financial Disclosures:

The following planners, faculty, and reviewers have the following relevant financial relationships with commercial interests to disclose:

Dr. Phelps has disclosed the following relationships:

McGraw-Hill: book on bipolar disorder
W.W. Norton & Co.: books on bipolar disorder

All of the relevant financial relationships listed for these individuals have been mitigated.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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