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To the Editor: In their prospective naturalistic investigation, Dr Cohen and colleagues¹ showed that among women who maintained their antidepressant use throughout the pregnancy, 26% had a relapse of major depression, compared with 68% of those who discontinued taking their antidepressants. They also found that women who increased or decreased their antidepressant use had a rate of relapse between those who maintained and those who discontinued their antidepressants (45% and 35%, respectively). The authors concluded that women with histories of depression who are euthymic while receiving antidepressant therapy should be aware of the association of depressive relapse during pregnancy with antidepressant discontinuation. These findings are very similar to those of lithium treatment for bipolar disorder during pregnancy.

First, in the case of lithium continuation, Perlis et al² demonstrated that changes in serum lithium level in the maintenance phase (both low to standard and standard to low) were associated with recurrence . . . [Full Text of this Article]

Takeshi Terao, MD, PhD
terao@med.oita-u.ac.jp
Department of Neuropsychiatry
Oita University Faculty of Medicine
Oita, Japan

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