Antidepressant Discontinuation During Pregnancy Linked to Increased Mental Health Risks

Pregnant patients who stop taking antidepressant medication during pregnancy are nearly twice as likely to experience a mental health emergency, according to fresh research presented at the Society for Maternal-Fetal Medicine (SMFM) 2026 Pregnancy Meeting¹. This finding underscores the critical need to prioritize mental health care for expectant mothers and offer a full range of treatment options, including continued medication when clinically appropriate.

The Study Findings

Researchers from the University of Pennsylvania in Philadelphia examined de-identified records from Independence Blue Cross, a state-based private insurance database, of 3,983 patients who gave birth between January 1, 2023, and December 31, 2024¹. All patients had been diagnosed with depression or anxiety before pregnancy and had an active prescription for an SSRI or SNRI antidepressant three months prior to becoming pregnant.

The study revealed that patients who discontinued antidepressants during pregnancy were more likely to have a mental health emergency, with peaks observed in the first and ninth months of pregnancy². Specifically, there were 58 mental health emergency visits per 1,000 patients in the first month compared to 37 per 1,000 for those who continued medication (P=0.027). In the ninth month and immediate postpartum period, the rates were 59 per 1,000 versus 29 per 1,000 (P=0.001)².

Researchers found no significant differences in outpatient or emergency room visits for mental health indications prior to pregnancy between patients who continued taking their antidepressant and those who did not¹.

Why This Matters

Mental health disorders are a leading contributor to maternal mortality in the U.S.¹. Untreated or undertreated depression during pregnancy carries significant health risks, including suicide, preterm birth, preeclampsia, and low birth weight¹. Available data suggest that SSRI antidepressant use during pregnancy is not associated with congenital anomalies, fetal growth problems, or long-term developmental problems¹.

Discontinuation Patterns

The study found that approximately 17.8% of patients had no medication fills during pregnancy, and 64.6% experienced a gap of 60 days or more in their medication refills². Discontinuation rates were similar across trimesters, ranging from 29.7% in the first trimester to 38.6% in the third².

Discontinuation was least likely when the antidepressant was prescribed by an ob/gyn compared to family medicine and internal medicine prescribers¹.

Expert Perspective

“These findings, while not entirely surprising to those who work with pregnant patients who suffer from mental health conditions, are so crucial to consider for maternal health policy,” said Kelly B. Zafman, MD, of the University of Pennsylvania². “This work underscores the need to take pregnant patients’ mental health seriously and to offer the full range of treatment options — including medications when clinically appropriate.”

The American College of Obstetricians &amp. Gynecologists recommends against withholding or discontinuing medications for mental health conditions due to pregnancy or lactation status alone¹.

Looking Ahead

Future research should focus on assessing racial disparities in medication discontinuation and developing strategies to encourage patients to continue taking prescribed medications during pregnancy. Addressing the maternal mental health crisis is essential to reducing maternal morbidity and mortality in the United States¹.