Discontinuation of antidepressants during attempts to conceive

A pilot trial of cognitive behavioral therapy for the prevention of recurrent depression

Christina Psaros, Marlene Freeman, Steven Safren, Maria Barsky, Lee S. Cohen

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Many women discontinue antidepressants (ADs) when trying to conceive, although risk of depressive relapse is high. We examined the feasibility and potential clinical effect of cognitive behavioral therapy for the prevention of recurrence (CBT-PR) for women with a history of recurrent major depressive disorder (MDD) who planned to discontinue maintenance AD treatment for pregnancy. METHODS: This was an open preliminary study of CBT-PR in women (N = 12) planning or early in pregnancy with remitted MDD on maintenance ADs with a plan to discontinue ADs for pregnancy. Participants received 12 sessions of CBT-PR during the acute phase and optional monthly booster sessions during follow-up. Participants were assessed monthly during the acute phase and then twice additionally during follow-up by an independent rater using mood scales (depression module of the Mini-International Neuropsychiatric Interview and Montgomery-Åsberg Depression Rating Scale); pregnancy status was also assessed. RESULTS: Over the 24 weeks of the trial, 75% (n = 9) of participants did not restart ADs and did not relapse to depression. Of the 3 who reintroduced AD, 2 experienced a depressive relapse, whereas one did not meet full criteria for MDD. Adherence to the intervention was very good with all participants completing all therapy sessions and assessments. CONCLUSIONS: Cognitive behavioral therapy for the prevention of recurrence seems feasible and may provide protection for women with recurrent depression on ADs who discontinue their medication while trying to conceive. The extent to which euthymia is sustainable with CBT-PR requires further study; the results of which may broaden treatment choices for women in anticipation of and during pregnancy.

Original languageEnglish (US)
Pages (from-to)455-460
Number of pages6
JournalJournal of Clinical Psychopharmacology
Volume34
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Cognitive Therapy
Antidepressive Agents
Depression
Recurrence
Major Depressive Disorder
Pregnancy
Maintenance
Therapeutics
Interviews

Keywords

  • antidepressants
  • behavior therapy
  • CBT
  • depression
  • pregnancy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Medicine(all)

Cite this

Discontinuation of antidepressants during attempts to conceive : A pilot trial of cognitive behavioral therapy for the prevention of recurrent depression. / Psaros, Christina; Freeman, Marlene; Safren, Steven; Barsky, Maria; Cohen, Lee S.

In: Journal of Clinical Psychopharmacology, Vol. 34, No. 4, 2014, p. 455-460.

Research output: Contribution to journalArticle

@article{dfb71cace99b4391b990a78d9da545b5,
title = "Discontinuation of antidepressants during attempts to conceive: A pilot trial of cognitive behavioral therapy for the prevention of recurrent depression",
abstract = "BACKGROUND: Many women discontinue antidepressants (ADs) when trying to conceive, although risk of depressive relapse is high. We examined the feasibility and potential clinical effect of cognitive behavioral therapy for the prevention of recurrence (CBT-PR) for women with a history of recurrent major depressive disorder (MDD) who planned to discontinue maintenance AD treatment for pregnancy. METHODS: This was an open preliminary study of CBT-PR in women (N = 12) planning or early in pregnancy with remitted MDD on maintenance ADs with a plan to discontinue ADs for pregnancy. Participants received 12 sessions of CBT-PR during the acute phase and optional monthly booster sessions during follow-up. Participants were assessed monthly during the acute phase and then twice additionally during follow-up by an independent rater using mood scales (depression module of the Mini-International Neuropsychiatric Interview and Montgomery-{\AA}sberg Depression Rating Scale); pregnancy status was also assessed. RESULTS: Over the 24 weeks of the trial, 75{\%} (n = 9) of participants did not restart ADs and did not relapse to depression. Of the 3 who reintroduced AD, 2 experienced a depressive relapse, whereas one did not meet full criteria for MDD. Adherence to the intervention was very good with all participants completing all therapy sessions and assessments. CONCLUSIONS: Cognitive behavioral therapy for the prevention of recurrence seems feasible and may provide protection for women with recurrent depression on ADs who discontinue their medication while trying to conceive. The extent to which euthymia is sustainable with CBT-PR requires further study; the results of which may broaden treatment choices for women in anticipation of and during pregnancy.",
keywords = "antidepressants, behavior therapy, CBT, depression, pregnancy",
author = "Christina Psaros and Marlene Freeman and Steven Safren and Maria Barsky and Cohen, {Lee S.}",
year = "2014",
doi = "10.1097/JCP.0000000000000158",
language = "English (US)",
volume = "34",
pages = "455--460",
journal = "Journal of Clinical Psychopharmacology",
issn = "0271-0749",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Discontinuation of antidepressants during attempts to conceive

T2 - A pilot trial of cognitive behavioral therapy for the prevention of recurrent depression

AU - Psaros, Christina

AU - Freeman, Marlene

AU - Safren, Steven

AU - Barsky, Maria

AU - Cohen, Lee S.

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Many women discontinue antidepressants (ADs) when trying to conceive, although risk of depressive relapse is high. We examined the feasibility and potential clinical effect of cognitive behavioral therapy for the prevention of recurrence (CBT-PR) for women with a history of recurrent major depressive disorder (MDD) who planned to discontinue maintenance AD treatment for pregnancy. METHODS: This was an open preliminary study of CBT-PR in women (N = 12) planning or early in pregnancy with remitted MDD on maintenance ADs with a plan to discontinue ADs for pregnancy. Participants received 12 sessions of CBT-PR during the acute phase and optional monthly booster sessions during follow-up. Participants were assessed monthly during the acute phase and then twice additionally during follow-up by an independent rater using mood scales (depression module of the Mini-International Neuropsychiatric Interview and Montgomery-Åsberg Depression Rating Scale); pregnancy status was also assessed. RESULTS: Over the 24 weeks of the trial, 75% (n = 9) of participants did not restart ADs and did not relapse to depression. Of the 3 who reintroduced AD, 2 experienced a depressive relapse, whereas one did not meet full criteria for MDD. Adherence to the intervention was very good with all participants completing all therapy sessions and assessments. CONCLUSIONS: Cognitive behavioral therapy for the prevention of recurrence seems feasible and may provide protection for women with recurrent depression on ADs who discontinue their medication while trying to conceive. The extent to which euthymia is sustainable with CBT-PR requires further study; the results of which may broaden treatment choices for women in anticipation of and during pregnancy.

AB - BACKGROUND: Many women discontinue antidepressants (ADs) when trying to conceive, although risk of depressive relapse is high. We examined the feasibility and potential clinical effect of cognitive behavioral therapy for the prevention of recurrence (CBT-PR) for women with a history of recurrent major depressive disorder (MDD) who planned to discontinue maintenance AD treatment for pregnancy. METHODS: This was an open preliminary study of CBT-PR in women (N = 12) planning or early in pregnancy with remitted MDD on maintenance ADs with a plan to discontinue ADs for pregnancy. Participants received 12 sessions of CBT-PR during the acute phase and optional monthly booster sessions during follow-up. Participants were assessed monthly during the acute phase and then twice additionally during follow-up by an independent rater using mood scales (depression module of the Mini-International Neuropsychiatric Interview and Montgomery-Åsberg Depression Rating Scale); pregnancy status was also assessed. RESULTS: Over the 24 weeks of the trial, 75% (n = 9) of participants did not restart ADs and did not relapse to depression. Of the 3 who reintroduced AD, 2 experienced a depressive relapse, whereas one did not meet full criteria for MDD. Adherence to the intervention was very good with all participants completing all therapy sessions and assessments. CONCLUSIONS: Cognitive behavioral therapy for the prevention of recurrence seems feasible and may provide protection for women with recurrent depression on ADs who discontinue their medication while trying to conceive. The extent to which euthymia is sustainable with CBT-PR requires further study; the results of which may broaden treatment choices for women in anticipation of and during pregnancy.

KW - antidepressants

KW - behavior therapy

KW - CBT

KW - depression

KW - pregnancy

UR - http://www.scopus.com/inward/record.url?scp=84903760970&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84903760970&partnerID=8YFLogxK

U2 - 10.1097/JCP.0000000000000158

DO - 10.1097/JCP.0000000000000158

M3 - Article

VL - 34

SP - 455

EP - 460

JO - Journal of Clinical Psychopharmacology

JF - Journal of Clinical Psychopharmacology

SN - 0271-0749

IS - 4

ER -