Discontinuing antidepressants and benzodiazepines upon becoming pregnant -Beware of the risks of abrupt discontinuation

QUESTION Two of my patients are planning to become pregnant. One is taking paroxetine and the other lorazepam. We have discussed what to do when they become pregnant and have decided they should stop taking these drugs as soo n as pregnancy is confirmed. Is this the right decision? ANSWER The decision to discontinue these drugs during pregnancy should be b ased on scientific evidence rather than "hearsay" that women should not tak e psychotropic medications during pregnancy. Recent epidemiologic studies h ave documented the relative safety of these drugs, so women should not feel compelled to stop taking them when they become pregnant. If. after receivi ng appropriate evidence-based information, a woman decides to stop taking t he drugs, they should be gradually tapered off to avoid abrupt discontinuat ion syndrome.