PharmaSafe’s PhD Student Alexis Carson Published her first paper on Antidepressent use during pregnancy!

We are proud to celebrate Alexis Carson, a dedicated PhD student in the PharmaSafe research group on publishing her first paper of her PhD. Since joining the program in Fall 2023, Alexis has been actively exploring the topic of maternal antidepressant use during pregnancy and its potential effects on child health, with a particular focus on metabolic outcomes such as childhood type 1 diabetes. 

Recently, Alexis published her first paper titled “Initiating Antidepressant Treatment in Pregnancy: Timing, Intensity, and Influential Maternal and Familial Factors.” This study provides a comprehensive description of 1,879 women who reported new episodes of depression or anxiety during pregnancy, with a focus on the timing and intensity of antidepressant initiation. By addressing these factors, Alexis has gained a solid foundation for her future research, understanding the research population and filling in gaps for what to look for when conducting subsequent studies. 

Key Highlights from the Study: 

  • 81.6% of antidepressant initiators discontinued treatment, primarily during early pregnancy. 

  • Identified three prescription fill trajectories: 

    • Early-pregnancy initiators with rapid discontinuation (n = 41, 47.1%) 

    • Early-pregnancy initiators with mid-pregnancy discontinuation (n = 30, 34.5%) 

    • Early-mid pregnancy initiators with continuation (n = 16, 18.4%) 

  • Three dose trajectories were also established: 

    • Low dose with discontinuation (n = 45, 51.7%) 

    • High dose with discontinuation (n = 26, 29.9%) 

    • Medium dose with continuation (n = 16, 18.4%) 

  • Pre-pregnancy use of other psychotropic medications increased the likelihood of women being early initiators with mid-pregnancy discontinuation and high-dose discontinuers compared to those who were unmedicated. This underscores the importance of considering a woman's full medication profile when examining antidepressant use during pregnancy. 

  • Thyroid disorder was significantly associated with early initiators who experienced rapid discontinuation (adjusted relative risk ratios aRRR: 4.15, 95% CI: 1.56–11.03). 

  • Higher maternal genetic susceptibility to depression was strongly associated Early initiators with mid-pregnancy discontinuation (aRRR=8.57, 95% CI: 3.09-23.74), High dose discontinuers and Medium dose continuers across comparisons. Additionally, Adverse reproductive history, immigration and alcohol pre-pregnancy emerged as important factors. 

As Alexis works on additional papers for her PhD, she reflects on the challenges of working with a small sample size, noting the complexity of focusing on women who initiated antidepressant treatment during pregnancy without prior use of these medications or had a history of depression or anxiety. Alexis looks forward to focusing on comedication use during pregnancy and the potential effects of multiple medication use patterns on outcomes. The factors identified in this study can also be utilized by clinicians to provide personalized treatment guidance for women experiencing depression or anxiety during pregnancy. 

Alexis with Paper
Photo: Private

Despite facing challenges, including the loss of her main supervisor, Angela Lupattelli, in January 2025, Alexis continues to forge ahead in her research. Reflecting on her PhD experience, she shares, “I have attended three major conferences, two writing retreats, and countless opportunities to meet and network with others in the field. The only things that could make this better is if Angela was here to celebrate this too.” Angela’s guidance as the last author of Alexis’s recent paper was invaluable, and her legacy continues to inspire our research community. 

This spring, Alexis also expanded her research through a collaborative stay at Karolinska Institute in Sweden, where she integrated Swedish data into her future work on type 1 diabetes after prenatal exposure to antidepressants. Under supportive mentorship of Dr. Carolyn Cesta, Alexis has gained insights into the function and dynamics of another renowned research group. 

Alexis will continue her PhD under the guidance of Hedvig Nordeng, who has stepped up as her main supervisor, as well as Nhung Trinh, ensuring that Alexis receives the support she needs as she progresses further in her studies. We look forward to following her progress and the contributions she will undoubtedly make to the field of maternal and child health. 

Read the full paper here: Initiating antidepressant treatment in pregnancy: Timing, intensity, and influential maternal and familial factors - PubMed 

Published Aug. 8, 2025 10:04 AM - Last modified Aug. 8, 2025 1:45 PM
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