SSRIs in Pregnancy —What Offspring Brain Volumes Can and Cannot Tell Us—Reply

In Reply We appreciate Ceulemans and colleagues ’ response. We share their concern regarding the potential for misinterpretation and preemptive clinical implications of our study of selective serotonin reuptake inhibitor (SSRI) use during pregnancy. We also agree that discontinuing prenatal SSRI treatment can increase the risk of psychiatric em ergencies and postpartum relapse. We certainly did not advocate against SSRI treatment during pregnancy or recommend discontinuation of treatment. At the same time, we recognize that there are effective alternatives to SSRI treatment and that most women taking SSRIs during pregnancy are taking maint enance treatment. In our study, all women had initiated SSRI treatment before conception. Thus, the results should not be generalized to women who consider commencing treatment in pregnancy. We propose further research and discussion of possible risks and unwanted effects of discontinuing or continu ing treatment. Our vision is a more personalized treatment, eg, for asymptomatic women on maintenance therapy who are planning a pregnancy.
Source: JAMA Psychiatry - Category: Psychiatry Source Type: research