Pregnancy doesn't protect against depression relapse.

Women who discontinue taking medication for depression during pregnancy are almost three times as likely to experience a relapse as those who continue their medication regimen, according to research published in the Journal of the American Medical Association (JAMA).

The study, conducted at three medical centers that specialize in the treatment of psychiatric illness during pregnancy, refutes the traditional view that hormonal changes associated with pregnancy offer "protection" from emotional discomfort and psychiatric disorder. Of the 82 women who maintained their medication throughout their pregnancy, 21 (26 percent) relapsed; of the 65 who discontinued their medication, 44 (68 percent) relapsed. The overall rate of relapse was 43 percent. To participate in the study, women had to meet the following conditions:

* A history of major depression prior to pregnancy;

* Less than 16 weeks' gestation;

* Euthymic (i.e., in a normal mood; neither elated nor depressed) for at least three months prior to their last menstrual period; and

* Currently or recently receiving antidepressant medication.

Of the women who relapsed, half did so during their first trimester. Women older than 32 years of age were 60 percent less likely to relapse than younger women. Those who had been suffering from depression for more than five years and those who had suffered more than four episodes of depressive illness were much more likely to relapse.

For more information about the study, see the February 1 issue of JAMA.