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Antidepressant discontinuation during pregnancy and relapse risk in the perinatal period

Project description

Towards personalised anti-depressant therapy in pregnancy

Up to 10 % of women take antidepressant medication during pregnancy. However, half of them stop treatment in fear of the potential impact on the embryo. Treatment discontinuation increases the risk of relapse with profound consequences. Since evidence so far relies purely on epidemiological data, in order to determine the risk factors, the EU-funded PregnancyAD project will integrate demographics, clinical features and genetic data from a large representative population in Denmark. Addressing the genetics knowledge gap in the field will help identify women at high risk of relapse after discontinuing antidepressants during pregnancy. More importantly, it will contribute towards optimal antidepressant treatment recommendations during pregnancy.

Objective

Antidepressants are the mainstay of pharmacological treatment for depressive and anxiety disorders in the perinatal period, and up to one in ten pregnant women take them. Among these women, over 50% discontinue antidepressants during pregnancy due to fear of possible adverse fetal effects. However, discontinuation may increase the risk of relapse, which can also have profound negative impacts. Evidence on perinatal relapse risk following antidepressant discontinuation during pregnancy is sparse and limited to highly selected populations. Moreover, the only factors considered in studies so far have been simple demographics and clinical features, while genetic profiling is conspicuously absent.

The project aims to address knowledge gaps which urgently need to be understood in order for clinical care to provide personalized antidepressant treatment recommendations around pregnancy. This overarching objective will identify women at low or high relapse risk after discontinuing antidepressants during pregnancy and determine risk factors of relapse to enable personal risk estimates for the first time, in a large representative population, combining demographics, clinical features and genetic data retrieved from Danish national registers and the Integrative Psychiatric Research (iPSYCH) cohort.

The project will provide a unique opportunity due to its multidisciplinary nature and innovative combinations of genetics and epidemiology. The proposed research will benefit from the expertise in genetics, genomics, and psychiatric epidemiology of the supervisors, and the fellow’s multidisciplinary skills in epidemiology and biostatistics applied on large, highly complicated datasets. The fellow will acquire state-of-the-art skills in the analysis of genetic data, planning, and management by training-through-research along with coursework. This project will form a fundamental leap towards her future independent career as a leading and international recognized epidemiologist.

Coordinator

AARHUS UNIVERSITET
Net EU contribution
€ 201 392,64
Address
NORDRE RINGGADE 1
8000 Aarhus C
Denmark

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Region
Danmark Midtjylland Østjylland
Activity type
Higher or Secondary Education Establishments
Links
Total cost
€ 201 392,64

Partners (1)