What happens when pregnant people discontinue antidepressants?

Lead

A study abstract presented at the Society for Maternal-Fetal Medicine’s annual meeting on February 11, 2026, found that people who stop antidepressant medication during pregnancy face a substantially higher risk of acute mental-health crises than those who continue treatment. Researchers analyzed records from a state-based private insurance database covering nearly 4,000 pregnant patients prescribed SSRIs or SNRIs and reported that those who discontinued their medication were almost twice as likely to experience a mental-health emergency. The risk spike was concentrated in the first and ninth months of pregnancy. Study authors emphasized that, based on these findings, mental-health treatment should not be withheld during pregnancy.

Key takeaways

• Source and design: The finding comes from an abstract presented at the SMFM meeting (Feb. 11, 2026) based on a state-level private insurance claims database covering roughly 4,000 pregnant patients.
• Discontinuation common: The majority of patients with SSRI or SNRI prescriptions stopped those medications during pregnancy, according to the abstract.
• Increased acute risk: People who discontinued antidepressants were reported to be almost twice as likely to have a mental-health emergency compared with those who continued treatment.
• Timing of crises: Emergency events clustered in month 1 and month 9 of pregnancy, suggesting early- and late-gestation vulnerability windows.
• Clinical message: Authors concluded that treatment for mental-health conditions should not be withheld during pregnancy and highlighted need for monitoring.
• Policy context: The finding arrives as an FDA advisory process has recently raised questions about antidepressant risks in pregnancy and possible label changes, which could influence prescribing behavior.
• Limitations: The data derive from insurance claims and an unpublished abstract; absolute event rates and causal mechanisms were not detailed in the abstract.

Background

Depression and anxiety are common in people of reproductive age, and selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are frequently prescribed. Clinical guidance over the past decade has emphasized weighing the risks of medication exposure against the well-documented harms of untreated maternal mental illness, including relapse, self-harm, and complications for fetal care and postpartum functioning.

Pregnancy often prompts medication reassessment. Concerns about fetal exposure, evolving evidence on specific birth outcomes, and public discussion — including recent advisory panels that have questioned antidepressant safety during pregnancy — have contributed to higher rates of elective discontinuation. At the same time, policy signals such as possible label changes by the FDA can alter clinicians’ and patients’ decisions well before definitive, peer-reviewed evidence is published.

Main event

The abstract reported at SMFM analyzed claims from a state-based private insurer dataset encompassing nearly 4,000 pregnant patients with an active prescription for an SSRI or SNRI. Investigators classified patients by whether they continued prescriptions during pregnancy or discontinued them and then tracked occurrences of mental-health emergencies recorded in claims data.

Key results presented were that the cohort who discontinued antidepressants had an approximately twofold higher likelihood of experiencing an emergency psychiatric event than the group that continued medication. The investigators highlighted two temporal peaks in emergency visits: the first month after conception and the ninth month of pregnancy, periods investigators suggested may reflect particular stressors or physiological changes.

The abstract notes that most patients with prescriptions did in fact stop their SSRIs or SNRIs during pregnancy, although the researchers did not publish detailed absolute event rates or the specific criteria used to define an emergency in the abstract format. The authors concluded that withholding treatment for mental-health conditions during pregnancy is not advisable based on these patterns.

Analysis & implications

Clinically, the study underscores the trade-off clinicians and patients face: potential medication-associated fetal risks versus the demonstrable harms of untreated maternal mental illness. An almost twofold increase in acute psychiatric emergencies is a nontrivial signal because emergencies correlate with morbidity for both parent and fetus, including risk of hospitalization, interruption of prenatal care, and impaired maternal self-care.

Policy and regulatory actions that emphasize possible medication harms without equal focus on relapse risk can unintentionally steer patients toward discontinuation. If the FDA moves toward stronger pregnancy warnings on antidepressants, prescribers and patients may interpret such guidance as a reason to stop treatment, increasing population-level relapse risk unless counterbalanced by system-level supports for nonpharmacologic care and close monitoring.

From a research standpoint, the study — presented as an abstract based on claims data — highlights gaps that should be filled by peer-reviewed analyses: absolute incidence rates, stratification by specific agents and doses, adjustment for baseline illness severity, and the role of nonpharmacologic treatments. Claims-based signals are valuable for hypothesis generation but cannot by themselves establish causality or capture clinical nuances such as adherence vs. intentional discontinuation.

Comparison & data

The table summarizes the key methodological points available from the abstract. Because the report was an abstract rather than a full peer-reviewed article, detailed breakdowns (for example, absolute emergency rates, specific drug-level risks, or adjustment variables) were not provided in the conference presentation; those details are necessary to interpret how broadly the relative-risk figure applies across subgroups.

Reactions & quotes

Presenters and commentators at the SMFM meeting framed the findings as a caution against reflexive discontinuation without clinical follow-up or alternative supports.

“Treatment for mental-health conditions should not be withheld during pregnancy.”

Study authors (SMFM abstract)

This concise conclusion was offered in the abstract as the investigators’ principal take-away, emphasizing that the observed association argues for continued access to care rather than automatic cessation of pharmacotherapy.

“Emergency visits clustered in the first and ninth months, which may indicate high-vulnerability windows requiring closer monitoring.”

Study authors (SMFM abstract)

The presenters urged clinicians to consider proactive monitoring plans for people who stop medication, especially during early pregnancy and late gestation, and to discuss alternatives such as psychotherapy or stepped-up outpatient support where appropriate.

Unconfirmed

• Whether the reported relative risk reflects a causal effect of stopping medication rather than confounding by indication or illness severity remains unconfirmed because the abstract did not present full adjustment details.
• Exact absolute rates of emergency events (per 1,000 pregnancies) and detailed breakdowns by specific drugs, doses, or demographic subgroups were not provided in the abstract and therefore are unconfirmed.
• Potential regulatory outcomes — including any final FDA labeling changes for antidepressants in pregnancy — remain undecided and were not settled at the time of presentation.

Bottom line

This conference abstract adds to evidence that discontinuing antidepressants in pregnancy is associated with higher short-term risk of acute psychiatric emergencies, with notable peaks early and late in gestation. The finding reinforces the clinical principle that treatment decisions during pregnancy must balance maternal stability against potential fetal concerns rather than defaulting to cessation.

For clinicians and patients, the practical implications are to favor individualized counseling, careful monitoring if medications are stopped, and ready access to alternative therapies and crisis resources. For policymakers and guideline panels, the study signals the importance of pairing any regulatory caution about fetal exposure with clear guidance and resources to prevent and manage maternal relapse.

Sources

• STAT — What happens when pregnant people discontinue antidepressants? (news outlet: coverage of SMFM abstract)
• Society for Maternal-Fetal Medicine — Annual Meeting (abstracts) (official: professional society/meeting abstracts)
• U.S. Food and Drug Administration — Advisory committee materials (official: regulatory agency)