Tapering Antidepressants While Receiving Digital Preventive Cognitive Therapy During Pregnancy: An Experience Sampling Methodology Trial

Marlies E Brouwer; Nina M Molenaar; Huibert Burger; Alishia D Williams; Casper J Albers; Mijke P Lambregtse-van den Berg; Claudi L H Bockting

doi:10.3389/fpsyt.2020.574357

Tapering Antidepressants While Receiving Digital Preventive Cognitive Therapy During Pregnancy: An Experience Sampling Methodology Trial

Marlies E Brouwer
, Nina M Molenaar
, Huibert Burger
, Alishia D Williams
, Casper J Albers
, Mijke P Lambregtse-van den Berg
, Claudi L H Bockting^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

12 Citations (Scopus)

120 Downloads (Pure)

Abstract

Background: Previous studies indicated that affect fluctuations, the use of antidepressant medication (ADM), as well as depression during pregnancy might have adverse effects on offspring outcomes. The aim of the current proof-of-principle study is to explore the effect of tapering ADM while receiving online preventive cognitive therapy (PCT) on pregnant women and the offspring as compared to pregnant women continuing ADM.

Objectives: We sought to compare positive and negative affect fluctuations in pregnant women receiving online PCT while tapering ADM vs. pregnant women continuing ADM, and to investigate if affect fluctuations in early pregnancy were related to offspring birth weight.

Method: An experience sampling methodology (ESM)-trial ran alongside a Dutch randomized controlled trial (RCT) and prospective observational cohort of women using ADM at the start of pregnancy. In the ESM-trial fluctuations of positive and negative affect were assessed in the first 8 weeks after inclusion. Recurrences of depression were assessed up to 12 weeks post-partum, and birth records were used to assess offspring birth weight. The RCT has been registered at the Netherlands Trial Register (NTR4694, ).

Results: In total, 19 pregnant women using ADM at start of their pregnancy participated in the ESM-trial. There were no significant differences in positive and negative affect fluctuations, nor recurrence rates between women receiving PCT while tapering ADM vs. women continuing ADM. We found no association between affect fluctuations, pre-natal depressive symptoms, and birth weight (all p > 0.05).

Conclusion: This explorative study showed that tapering ADM while receiving online PCT may protect pregnant women against recurrences of depression and affect fluctuations, without affecting birth weight. There is a high need for more controlled studies focusing on tapering ADM with (online) psychological interventions during pregnancy.

Original language	English
Article number	574357
Pages (from-to)	1-11
Number of pages	11
Journal	Frontiers in Psychiatry
Volume	11
DOIs	https://doi.org/10.3389/fpsyt.2020.574357
Publication status	Published - 22-Oct-2020

Keywords

pregnancy
preventive cognitive therapy
antidepressants
tapering and discontinuation
offspring
experience sampling methodology (ESM)
proof-of-principle
MAJOR DEPRESSIVE DISORDER
SEROTONIN REUPTAKE INHIBITORS
CRITICAL SLOWING-DOWN
NEGATIVE AFFECT
SEQUENTIAL INTEGRATION
PERINATAL DEPRESSION
MATERNAL MOOD
RELAPSE
METAANALYSIS
INTERVENTIONS

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@article{75241039d5ea481183601a6b64782cad,

title = "Tapering Antidepressants While Receiving Digital Preventive Cognitive Therapy During Pregnancy: An Experience Sampling Methodology Trial",

abstract = "Background: Previous studies indicated that affect fluctuations, the use of antidepressant medication (ADM), as well as depression during pregnancy might have adverse effects on offspring outcomes. The aim of the current proof-of-principle study is to explore the effect of tapering ADM while receiving online preventive cognitive therapy (PCT) on pregnant women and the offspring as compared to pregnant women continuing ADM.Objectives: We sought to compare positive and negative affect fluctuations in pregnant women receiving online PCT while tapering ADM vs. pregnant women continuing ADM, and to investigate if affect fluctuations in early pregnancy were related to offspring birth weight.Method: An experience sampling methodology (ESM)-trial ran alongside a Dutch randomized controlled trial (RCT) and prospective observational cohort of women using ADM at the start of pregnancy. In the ESM-trial fluctuations of positive and negative affect were assessed in the first 8 weeks after inclusion. Recurrences of depression were assessed up to 12 weeks post-partum, and birth records were used to assess offspring birth weight. The RCT has been registered at the Netherlands Trial Register (NTR4694, ).Results: In total, 19 pregnant women using ADM at start of their pregnancy participated in the ESM-trial. There were no significant differences in positive and negative affect fluctuations, nor recurrence rates between women receiving PCT while tapering ADM vs. women continuing ADM. We found no association between affect fluctuations, pre-natal depressive symptoms, and birth weight (all p > 0.05).Conclusion: This explorative study showed that tapering ADM while receiving online PCT may protect pregnant women against recurrences of depression and affect fluctuations, without affecting birth weight. There is a high need for more controlled studies focusing on tapering ADM with (online) psychological interventions during pregnancy.",

keywords = "pregnancy, preventive cognitive therapy, antidepressants, tapering and discontinuation, offspring, experience sampling methodology (ESM), proof-of-principle, MAJOR DEPRESSIVE DISORDER, SEROTONIN REUPTAKE INHIBITORS, CRITICAL SLOWING-DOWN, NEGATIVE AFFECT, SEQUENTIAL INTEGRATION, PERINATAL DEPRESSION, MATERNAL MOOD, RELAPSE, METAANALYSIS, INTERVENTIONS",

author = "Brouwer, \{Marlies E\} and Molenaar, \{Nina M\} and Huibert Burger and Williams, \{Alishia D\} and Albers, \{Casper J\} and \{Lambregtse-van den Berg\}, \{Mijke P\} and Bockting, \{Claudi L H\}",

note = "Copyright {\textcopyright} 2020 Brouwer, Molenaar, Burger, Williams, Albers, Lambregtse-van den Berg and Bockting.",

year = "2020",

month = oct,

day = "22",

doi = "10.3389/fpsyt.2020.574357",

language = "English",

volume = "11",

pages = "1--11",

journal = "Frontiers in Psychiatry",

issn = "1664-0640",

publisher = "Frontiers Media S.A.",

}

TY - JOUR

T1 - Tapering Antidepressants While Receiving Digital Preventive Cognitive Therapy During Pregnancy

T2 - An Experience Sampling Methodology Trial

AU - Brouwer, Marlies E

AU - Molenaar, Nina M

AU - Burger, Huibert

AU - Williams, Alishia D

AU - Albers, Casper J

AU - Lambregtse-van den Berg, Mijke P

AU - Bockting, Claudi L H

PY - 2020/10/22

Y1 - 2020/10/22

N2 - Background: Previous studies indicated that affect fluctuations, the use of antidepressant medication (ADM), as well as depression during pregnancy might have adverse effects on offspring outcomes. The aim of the current proof-of-principle study is to explore the effect of tapering ADM while receiving online preventive cognitive therapy (PCT) on pregnant women and the offspring as compared to pregnant women continuing ADM.Objectives: We sought to compare positive and negative affect fluctuations in pregnant women receiving online PCT while tapering ADM vs. pregnant women continuing ADM, and to investigate if affect fluctuations in early pregnancy were related to offspring birth weight.Method: An experience sampling methodology (ESM)-trial ran alongside a Dutch randomized controlled trial (RCT) and prospective observational cohort of women using ADM at the start of pregnancy. In the ESM-trial fluctuations of positive and negative affect were assessed in the first 8 weeks after inclusion. Recurrences of depression were assessed up to 12 weeks post-partum, and birth records were used to assess offspring birth weight. The RCT has been registered at the Netherlands Trial Register (NTR4694, ).Results: In total, 19 pregnant women using ADM at start of their pregnancy participated in the ESM-trial. There were no significant differences in positive and negative affect fluctuations, nor recurrence rates between women receiving PCT while tapering ADM vs. women continuing ADM. We found no association between affect fluctuations, pre-natal depressive symptoms, and birth weight (all p > 0.05).Conclusion: This explorative study showed that tapering ADM while receiving online PCT may protect pregnant women against recurrences of depression and affect fluctuations, without affecting birth weight. There is a high need for more controlled studies focusing on tapering ADM with (online) psychological interventions during pregnancy.

AB - Background: Previous studies indicated that affect fluctuations, the use of antidepressant medication (ADM), as well as depression during pregnancy might have adverse effects on offspring outcomes. The aim of the current proof-of-principle study is to explore the effect of tapering ADM while receiving online preventive cognitive therapy (PCT) on pregnant women and the offspring as compared to pregnant women continuing ADM.Objectives: We sought to compare positive and negative affect fluctuations in pregnant women receiving online PCT while tapering ADM vs. pregnant women continuing ADM, and to investigate if affect fluctuations in early pregnancy were related to offspring birth weight.Method: An experience sampling methodology (ESM)-trial ran alongside a Dutch randomized controlled trial (RCT) and prospective observational cohort of women using ADM at the start of pregnancy. In the ESM-trial fluctuations of positive and negative affect were assessed in the first 8 weeks after inclusion. Recurrences of depression were assessed up to 12 weeks post-partum, and birth records were used to assess offspring birth weight. The RCT has been registered at the Netherlands Trial Register (NTR4694, ).Results: In total, 19 pregnant women using ADM at start of their pregnancy participated in the ESM-trial. There were no significant differences in positive and negative affect fluctuations, nor recurrence rates between women receiving PCT while tapering ADM vs. women continuing ADM. We found no association between affect fluctuations, pre-natal depressive symptoms, and birth weight (all p > 0.05).Conclusion: This explorative study showed that tapering ADM while receiving online PCT may protect pregnant women against recurrences of depression and affect fluctuations, without affecting birth weight. There is a high need for more controlled studies focusing on tapering ADM with (online) psychological interventions during pregnancy.

KW - pregnancy

KW - preventive cognitive therapy

KW - antidepressants

KW - tapering and discontinuation

KW - offspring

KW - experience sampling methodology (ESM)

KW - proof-of-principle

KW - MAJOR DEPRESSIVE DISORDER

KW - SEROTONIN REUPTAKE INHIBITORS

KW - CRITICAL SLOWING-DOWN

KW - NEGATIVE AFFECT

KW - SEQUENTIAL INTEGRATION

KW - PERINATAL DEPRESSION

KW - MATERNAL MOOD

KW - RELAPSE

KW - METAANALYSIS

KW - INTERVENTIONS

U2 - 10.3389/fpsyt.2020.574357

DO - 10.3389/fpsyt.2020.574357

M3 - Article

C2 - 33192705

SN - 1664-0640

VL - 11

SP - 1

EP - 11

JO - Frontiers in Psychiatry

JF - Frontiers in Psychiatry

M1 - 574357

ER -

Tapering Antidepressants While Receiving Digital Preventive Cognitive Therapy During Pregnancy: An Experience Sampling Methodology Trial

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