It has been emphasized that antidepressants are not contraindicated during pregnancy, although use of paroxetine is not preferable [Stewart, 2011; Koren and Nordeng, 2012]. To avoid feelings of guilt women, have to make their own decision to (dis)continue the antidepressant, together with their partner. In consultation with the physician, Alisertib concentration Patients can consider the possibilities of discontinuing or decreasing the dose in late pregnancy. Inhibitors,research,lifescience,medical This to mitigate the risk of persistent pulmonary hypertension of the newborn infant (PPHN) or withdrawal syndrome [Koren and Nordeng, 2012]. Women and their newborns included in the POP protocol were observed for at least

the first 48 hours after birth. Study population Women ≥18 years were included during the first trimester of pregnancy after signing informed consent if it was to be expected that

antidepressant medication would be used throughout all trimesters. Patients who were incapable of following the study protocol according to the attending Inhibitors,research,lifescience,medical specialist from the POP protocol were excluded. Adherence assessment To assess a daily practice method compared to MEMS, we used three different adherence methods: pill count, Beliefs about Medicine questionnaire (BMQ) and blood level monitoring. Medication Event Monitoring System The bottles were filled with the antidepressants Inhibitors,research,lifescience,medical with a MEMS 6 TrackCap 38 mm (Aardex Group Ltd, Switzerland) for 4 periods of 3 months. The MEMS bottles together with a diary to record deviations in intake of their antidepressant were supplied after inclusion. Patients were instructed to open the Inhibitors,research,lifescience,medical MEMS bottle only when they intended to take their medication. The patients

were made aware of the MEMS cap function prior to the start of the study. After the first supply, the patient was responsible during the rest of the study period for collecting the antidepressant at the hospital pharmacy. Primary investigators were not involved in dispensing study medication to avoid triggers for adherence. MEMS packages were analysed Inhibitors,research,lifescience,medical at the end of the study period with Powerview® (Aardex Group Ltd, Switzerland). Additional events, such as opening for refill or by accident, were removed from the MEMS data prior to analysis, according to dispensing protocols and notes from diaries. As an indicator to measure the adherence with MEMS we used dose-time, defined as the percentage of doses taken on schedule within 25% of the expected time interval (e.g. one-daily these dose should be taken 24 ± 6 hours apart) [Claxton et al. 2001]. The cut-off point for MEMS for good adherence was ≥80% [Brook et al. 2006]. Pill count Pill count was calculated at the end of the study program and the adherence was measured as: % Pill count = (number of prescribed pills − number of pills left in the bottle)/(number of days between dispensing date and return date of pill bottle) × 100. The cut-off point for good adherence was ≥90% [van Onzenoort et al. 2011].