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Letters to the Editor   |    
Response to Guille and Epperson Letter
Linda H. Chaudron, M.D., M.S.
Am J Psychiatry 2013;170:558a-559. doi:10.1176/appi.ajp.2013.13010092r
View Author and Article Information

The author’s disclosures accompany the original article.

From the Departments of Psychiatry, Pediatrics, and Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.

Copyright © 2013 by the American Psychiatric Association

Accepted January , 2013.

To the Editor: I want to thank Dr. Guille and Dr. Epperson for the complimentary comments and the additional important reference they provided regarding the risk for recurrence of depression during the perinatal period related to antidepressant use. As they point out, the findings by Yonkers et al. (1) highlight the complicated nature of predicting who will or will not have a recurrence of depression and who may or may not require antidepressants during the perinatal period. Drs. Guille and Epperson note that, while controlling for antidepressant use, a history of four or more depressive episodes puts women at high risk for a major depressive episode. In addition, Yonkers et al. identify other risk factors, such as having a depressive episode in the 6 months before pregnancy and being of black race or Hispanic ethnicity. These additional variables, as well as the fact that 16% of the women in the study developed major depression during pregnancy or the postpartum period, underscore the need for further research to more fully understand who is at highest risk for recurrence in the perinatal period and therefore what the risks and benefits of antidepressant treatment are for individual patients with a range of depression severity.

Yonkers  KA;  Gotman  N;  Smith  MV;  Forray  A;  Belanger  K;  Brunetto  WL;  Lin  H;  Burkman  RT;  Zelop  CM;  Lockwood  CJ:  Does antidepressant use attenuate the risk of a major depressive episode in pregnancy? Epidemiology 2011; 22:848–854
[PubMed]
 
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References

Yonkers  KA;  Gotman  N;  Smith  MV;  Forray  A;  Belanger  K;  Brunetto  WL;  Lin  H;  Burkman  RT;  Zelop  CM;  Lockwood  CJ:  Does antidepressant use attenuate the risk of a major depressive episode in pregnancy? Epidemiology 2011; 22:848–854
[PubMed]
 
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