If moderate to severe depressive symptoms, delay conceiving, continue and optimize meds until stable
If in early remission (started AD less than 6 months ago), delay conceiving, continue meds until stable
If in full remission, but history of both recurrence and non-response to psychotherapy, continue meds through pregnancy
If in full remission, no recurrent depression and/or positive prior response to therapy, taper off medication and refer for therapy
Pregnant, depressed, taking ADs
If depression is severe, continue and optimize meds
If depression is not severe:
If pt has either responded to therapy before or has never had therapy, start therapy either in combination with meds or (if symptoms are relatively mild) with a med taper
If pt has failed therapy, continue meds
Pregnant, depressed, not taking ADs
If depression is severe, start meds
If depression is not severe:
If pt has never failed a course of therapy, do therapy
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