Many women stop an SSRI or SNRI the day a pregnancy test turns positive, often without telling anyone. Stopping suddenly risks discontinuation symptoms and relapse, and untreated depression in pregnancy carries its own risks for mother and baby.
The better approach is a planned conversation, ideally before conception: how severe the illness has been, what happened at previous attempts to stop, and what she prefers. If she chooses to come off, a gradual taper with a follow-up plan is usual; if she continues, the lowest effective dose of a familiar drug is generally preferred over switching.
- Ask every woman of reproductive age on an antidepressant about pregnancy plans.
- Discuss past relapses on stopping before advising any change.
- If tapering, do it gradually with a named follow-up date.
- Avoid switching to an unfamiliar drug solely because of pregnancy.
Why it matters
The decision is often made alone at home in the first week after a positive test.
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