It is very common for mothers to be taking anti-depressant medication before, during or after a pregnancy. Women with depression who are pregnant or hoping to get pregnant may be alarmed at new research that points to a link between the use of selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, and the occurrence of autism in unborn kids.
In the study, published in the journal Archives of General Psychiatry, researchers led by Lisa Croen of Kaiser Permanente Northern California reviewed the medical records of more than 1,600 children, 298 of whom had autism spectrum disorders (ASDs). Essentially the study stated that children whose mothers take Zoloft, Prozac, Paxil, Celexa or similar antidepressants during pregnancy are twice as likely as other children to have a diagnosis of autism or a related disorder. This study is the first to examine the relationship between antidepressants and autism risk within children. But is this study too early to draw direct links? Or is it a step forward in understanding the links to autism and children?
The study, which was published Monday in the Archives of General Psychiatry, is a small initial investigation into what is likely to become a better-studied area of what causes children to develop the group of developmental and cognitive problems known as Autism Spectrum Disorder.
In my opinion, there are important limitations to the study, and the clinical implications are not entirely clear. In the general population, the researchers wrote, “the fraction of cases of ASD that may be attributed to use of antidepressants by the mother during pregnancy is less than 3 percent…and it is reasonable to conclude that prenatal SSRI exposure is very unlikely to be a major risk factor for ASD.” However, while they urged caution in interpreting the results, they said they believe the results do suggest a modest link between SSRIs and autism.
“Poor maternal mental health during pregnancy is a major public health issue,” Tim Oberlander, M.D., a professor of developmental pediatrics at the University of British Columbia, in Vancouver, told CNN.com. “Nontreatment is not an option. While some children might be at risk from an SSRI exposure–and we don’t know who, and how that works–there are many mothers and their children as well who will benefit.”
According to the Archives of General Psychiatry, classes of antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), may be especially risky early on in a pregnancy. Children who were exposed to the drugs during the first trimester were nearly four times as likely to develop an autism spectrum disorder (ASD) compared with unexposed children, according to the study.
Only 20 of the almost 300 children studied had been exposed to antidepressants in utero, so researchers urged further investigation and study.
Important Note: The study included fewer than 300 children with a diagnosed ASD and does not prove that taking SSRIs during pregnancy directly causes ASDs, which affect approximately 1 percent of children in the U.S. The findings will need to be confirmed in larger studies, and should not dissuade women from starting or continuing to take SSRIs, experts on prenatal drug exposure and mental health say.
I think that it is possible that a very intricate and well-designed study could reveal an even larger association between the use of antidepressants and ASD. Preliminary studies such as this recent one are very influential in research, because they open the door to new ideas and provide a stage for new studies that could provide much better solutions on this issue.
I question — where does this leave women who are pregnant and suffering from depression? I think that those women suffering should seek out help from their doctors and use their judgment in trying to balance the importance of treating depression, while understanding the possibility that using antidepressants could, in some cases, contribute to risk for ASD. All in all? The current research does not provide a definitive answer….but who knows in the future!