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Brief Reports   |    
Use of Antidepressant Medication in the United States During Pregnancy, 2002–2010
Matthew Ryan Meunier, M.D.; Ian M. Bennett, M.D., Ph.D.; Andrew S. Coco, M.D., M.S.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200455
View Author and Article Information

Dr. Meunier is with the Department of Family Medicine, Mayo Clinic, 200 First St., S.W., Rochester, MN 55905 (e-mail: meunier.matthew@mayo.edu). Dr. Bennett is with the Department of Family Medicine and Community Health, Perelman School of Medicine of the University of Pennsylvania, Philadelphia. Dr. Coco is with Department of Family and Community Medicine, Lancaster General Health, Lancaster, Pennsylvania.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  The authors analyzed prescribing for antidepressant medications during 27,328 prenatal visits in ambulatory settings in the United States between 2002 and 2010.

Methods  Data from the 2002–2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey were used to compare prescribing for antidepressant medication during visits for outpatient prenatal care between 2002–2006 and 2007–2010.

Results  Prenatal visits associated with a prescription for an antidepressant increased from .7% in 2002–2006 to 2.1% in 2007–2010 (p<.01). The proportion of prescriptions for selective serotonin reuptake inhibitors (SSRIs) declined (from 87% to 66%, p=.04), particularly for paroxetine (from 19% to <1%, p<.01).

Conclusions  Despite controversy over possible negative effects, prescribing of antidepressants during pregnancy increased between 2002 and 2010. SSRIs represented a smaller proportion of all antidepressants prescribed, and prescribing of paroxetine, likely in response to warnings by the U.S. Food and Drug Administration, dropped dramatically.

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Table 1Patient characteristics and prescribing of antidepressants for prenatal visits in the United States in 2002–2006 and 2007–2010, in percentages
Table Footer Note

a Specialties include family medicine (81%), internal medicine (4%), pediatrics (1%), general medical clinic (12%), and pediatric clinic (2%).

Table Footer Note

b Only years 2005 and 2006 (N=5,220) were included in the 2002–2006 period because of an expansion of chronic diagnostic categories in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data starting in 2005.

Table Footer Note

c Percentages of each antidepressant were determined by dividing the number of visits associated with each type by total number of visits associated with antidepressants (N=267).

Table Footer Note

d There were insufficient prescriptions in 2007–2010 to calculate a nationally representative percentage of antidepressants used.

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