We thank Lint for his comment on our article.1 Indeed, our 68% increase in the risk of spontaneous abortion with gestational use of antidepressants was based on prescriptions filled and not actual medication intake. The potential limitations associated with this were clearly stated in our article. We also highlighted that there is enough evidence-based research showing that the majority of pregnant women having a prescription filled will take at least one dose. Hence, our main definition of exposure categorized women dichotomously as having taken at least one dose. Our main finding replicates the results of a study by Einarson and colleagues,2 who showed that, based on women’s reports of actual medication intake, antidepressant use during gestation increased the risk of spontaneous abortion by 68%.
In this instance, actual antidepressant intake and antidepressant use defined by prescriptions filled gave concordant findings. The novelty of our study was its large sample size, which also enabled the study of antidepressant types and dosages.
Finally, there is no evidence showing that medical contact for antidepressant therapy increases the rate of pregnancy detection.