# Relapse risk after Discontinuation of Antidepressants during Pregnancy (R-DAP study)

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2021 · $547,142

## Abstract

Project Summary
Over the past decades, the use of antidepressants (ADs) as first-line treatment for both depressive and anxiety
disorders has increased exponentially, with females in their reproductive years using ADs twice as often as men.
Prior to conception or during pregnancy, approximately 50% of women on ADs (200,000 pregnant women in the
US each year) decide to discontinue their medication. While the wish to avoid in utero AD exposure to the fetus
is understandable, discontinuation of medication might lead to relapse, which can have a profound negative
impact on the health of mother and child. Unfortunately, general information on relapse risks after AD
discontinuation cannot be used during pregnancy and the postpartum period given the enormous changes in
physiology and emotion. Further, women discontinue AD prior to or during pregnancy regardless of their mood
stability, which has an impact on relapse risk. Only three small studies in highly selected populations have
investigated relapse risks during pregnancy and not a single study on AD discontinuation during pregnancy has
investigated the relapse risk postpartum.
 This study will quantify the relapse risk during pregnancy and postpartum after AD discontinuation, for
the first time, in a large and representative population sample. We will use the unique Danish national longitudinal
registers covering medication use since 1995 in the entire female population giving birth aged 15-49 years
(N=1,098,137). With our sample size, we will be able to identify both pregnancy specific and non-pregnancy
specific risk factors for relapse and timing to relapse. We will determine to which extent the perinatal period is
different in terms of relapse risks after AD discontinuation compared to other periods in a woman’s life. In
addition, we will explore if women with high genetic susceptibility for mood-disorders are more vulnerable for
relapse after AD discontinuation. In our last aim we will determine the long-term effects (up to 24 years) of
maternal relapse during pregnancy and the postpartum period on the offspring. We will conduct a sibling
comparison, in which we compare the health outcomes in children exposed to maternal relapse to their siblings
not exposed to maternal relapse in the perinatal period. We will explore if polygenic risk scores of the children
influence the association between their exposure to maternal relapse and their long-term psychiatric outcome,
considering in utero exposure to AD medication.

## Key facts

- **NIH application ID:** 10117285
- **Project number:** 5R01MH122869-02
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Veerle Bergink
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $547,142
- **Award type:** 5
- **Project period:** 2020-03-02 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10117285

## Citation

> US National Institutes of Health, RePORTER application 10117285, Relapse risk after Discontinuation of Antidepressants during Pregnancy (R-DAP study) (5R01MH122869-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10117285. Licensed CC0.

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