A 31-year-old woman at 10 weeks gestation presents for psychiatric consultation. She has a history of recurrent major depressive disorder with three prior episodes, the most severe of which involved suicidal ideation and a psychiatric hospitalization two years ago. She has been stable on sertraline 150 mg daily for the past 18 months and is currently in full remission. She is concerned about the effects of the medication on her developing baby and is asking whether she should discontinue sertraline. Her obstetrician has deferred the decision to the PMHNP. She has a strong family history of depression and reports that her previous attempts to taper off antidepressants resulted in relapse within two to three months.