Patients who increased their antidepressant
typically did so at least
once early on in pregnancy and often
continued that intensity of treatment.
However, others frequently increased
antidepressant on multiple occasions
across pregnancy (data not shown). Presumably,
such increases in antidepressant
somatotherapy would have been
instituted in response to subsyndromal
symptoms not initially reaching the
proportion of major depression but in
situations where such symptoms were
considered to be a harbinger of frank
depressive relapse. Thus, those women
who increased their antidepressant appear
quite distinct from a clinical perspective
than those who maintained
their antidepressant treatment across
the entire exposure period (12 weeks
before LMP until 16 weeks’ gestation),
a difference that is also reflected
in the nearly 3-fold higher risk of depressive
relapse between the 2 groups