A 28-year-old woman at 8 weeks of gestation presents to the GP with low mood and anxiety. She was previously stable on sertraline 100 mg daily, which ...

Question

A 28-year-old woman at 8 weeks of gestation presents to the GP with low mood and anxiety. She was previously stable on sertraline 100 mg daily, which she stopped 2 weeks ago because she was worried about harming the baby. She is now experiencing worsening symptoms with early morning wakening and poor appetite. Which is the single most appropriate advice?

Accepted Answer

Restart sertraline after discussing the balance of risks - untreated maternal depression carries greater risks than SSRI use in pregnancy

Answer

Reassure her that stopping sertraline was the right decision and offer CBT only

Answer

Switch to paroxetine as it is safer in pregnancy

Answer

Prescribe diazepam 5 mg twice daily as a bridge until delivery

Answer

Defer treatment until the second trimester when the risk period has passed

uk-drcog MCQ (SBA): Antidepressants in Pregnancy