SSRI Antidepressant Use During Pregnancy May Increase Autism Risk
Taking antidepressants during pregnancy may pose health risks for the baby, including certain birth defects affecting the heart and brain. A new study published in the journal Archives of General Psychiatry also finds that selective serotonin reuptake inhibitors (SSRI), one of the most popular classes of antidepressant medications, can also increase the risk of autism or a related disorder.
Study is Preliminary; Women Should Discuss Antidepressant Use With Their Doctors
Lisa Croen PhD, the director of autism research at Kaiser Permanente Northern California, used a database of information including more than 3.2 million people. She identified 298 children with an autism spectrum disorder (ASD) born between 1995 and mid 1999. These were matched with 1,507 healthy controls that were about the same age and born in the same hospitals. The mothers of all children were cross-checked for antidepressant use through a prescription database. The team focused on SSRI drugs such as Prozac, Zoloft, Luvox, Celexa, and Paxil or their generic equivalent.
Twenty of the children with an ASD (6.7%) were exposed to SSRI’s in the womb compared with 50 (3.3%) of the control children. After taking into account other factors which would affect autism risk, such as mother’s age, the researchers found that prenatal exposure to the antidepressant drugs increased the risk of an ASD 2.2-fold overall; first trimester exposure increased the risk 3.8-fold.
Coen estimates that perhaps a little more than 2% of all autism cases among children born in the late 1990s could be attributed to SSRI exposure, but that percentage might be higher today as SSRI use is more common than in years past.
Evidence from previous studies suggests that people with autism have abnormalities in their levels and regulation of serotonin, a brain chemical involved in many biological processes, including mood and behavior. Since SSRI’s pass through the placenta, the drugs could increase the levels of serotonin the baby is exposed to and influence the development of the neurotransmitter system.
Tim Oberlander MD, a professor of developmental pediatrics at the University of British Columbia, notes that the study does not prove that taking SSRIs during pregnancy directly causes autism spectrum disorders (ASD) and that the findings should not dissuade women from continuing to take the drugs if approved by their doctors. “Nontreatment is not an option,” he says, as untreated depression can lead to other health risks, such as preterm birth and growth problems.
Dr. Coen agrees, saying “The potential risks to the child really have to be balanced with the risk to the untreated mom.” A 2006 study showed that pregnant women who stopped taking antidepressants were five times more likely to experience a depression relapse than were pregnant women who continued taking the drugs. Other risks of abruptly stopping antidepressants include nausea and vomiting, chills, fatigue, insomnia, anxiety and irritability.
Arch Gen Psychiatry. Published online July 4, 2011. doi:10.1001/archgenpsychiatry.2011.73.