Pregnant individuals who stop taking their antidepressant medication face nearly twice the risk of experiencing a severe mental health crisis compared to those who continue their treatment, according to a landmark study presented at the 2026 Society for Maternal-Fetal Medicine (SMFM) Pregnancy Meeting. The findings, released in Las Vegas this week, highlight a critical gap in maternal healthcare: while fear of medication side effects drives many to discontinue treatment, the danger of untreated depression is often far greater.

Stopping Medication Spikes Crisis Risk

The study, led by Dr. Kelly B. Zafman of the University of Pennsylvania, analyzed data from nearly 4,000 pregnant patients with private insurance who had been diagnosed with depression or anxiety. Researchers found that patients who discontinued their SSRIs (selective serotonin reuptake inhibitors) or SNRIs were almost two times more likely to suffer a mental health emergency than those who stayed on their medication.

These emergencies included severe incidents such as suicidal ideation, psychosis, and substance overdose. The data revealed two distinct danger zones where the risk peaked significantly: the first month of pregnancy and the ninth month, just before delivery. Specifically, the rate of emergencies in the first month jumped from 37 per 1,000 in the continued-medication group to 58 per 1,000 in the discontinuation group.

"These findings... are so important to consider for maternal health policy," Dr. Zafman stated, emphasizing that the maternal mental health crisis is a leading driver of maternal mortality in the United States.

The "Cold Turkey" Phenomenon

Despite clinical guidelines, the study found that a staggering number of patients stop their medication. Approximately 17.8% of patients had no prescription fills at all during their pregnancy, and nearly two-thirds (64.6%) had a gap in medication of more than 60 days. This suggests that many individuals may be stopping their treatment abruptly upon learning they are pregnant, often without consulting a specialist.

This "cold turkey" approach is often driven by fears of birth defects—fears that recent data largely dispels. Comprehensive reviews in 2025 and 2026 have consistently shown that common antidepressants like sertraline (Zoloft) and fluoxetine (Prozac) carry minimal risks of congenital anomalies, whereas untreated prenatal depression is linked to tangible risks like preterm birth, low birth weight, and preeclampsia.

New Publication in Pregnancy Journal

The full results of this observational study have been published in the February 2026 issue of Pregnancy, the new official open-access journal of the Society for Maternal-Fetal Medicine. Launched in 2025 to provide a dedicated platform for high-impact obstetric research, the journal's feature of this study underscores its significance for clinical practice.

Key Statistics from the Study

  • 2x Risk: Discontinuing medication nearly doubles the chance of a mental health emergency.
  • High-Risk Periods: The first month (early pregnancy adaptation) and ninth month (pre-birth anxiety) are the most vulnerable times.
  • Discontinuation Rates: Over 64% of patients had a medication gap of 60+ days.

Expert Guidelines for 2026

In light of these findings, experts at the SMFM summit are urging healthcare providers to have proactive conversations with patients before conception or early in the first trimester. The consensus among maternal-fetal medicine specialists is clear: the goal is a healthy parent and a healthy baby, and for many, that means medication-supported pregnancy.

If you are pregnant and taking antidepressants, do not stop your medication without speaking to your doctor. The biological transition of pregnancy, combined with medication withdrawal, can create a "perfect storm" for a mental health crisis. Instead, discuss a management plan that balances your mental stability with fetal safety.