Antidepressant Use During Pregnancy Is Linked to Autism: Now What?
A new study shows that women who take antidepressants (SSRIs) while pregnant are much more likely to have a child with autism. Here's what else you should know.
By now you've probably heard the news: A new study has revealed that women who take antidepressants like Prozac, Zoloft, or Paxil during the final two trimesters of pregnancy are more likely to have a child with autism.
"Use of antidepressants, specifically selective serotonin reuptake inhibitors, during the second and/or third trimester increases the risk of autism spectrum disease in children, even after considering maternal depression," wrote Anick Berard of the University of Montreal in the report.
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Berard's team studied more than 145,000 children born between 1998 and 2009. They found that women who took antidepressants in the last six months of pregnancy were 87 percent more likely to have a child later diagnosed with autism. Doctors saw no increase in autism rates in women who took medication for depression in the first three months of pregnancy. And more careful analysis showed it is specifically SSRIs that are linked to the disorder.
Possibile causes for autism are always a hot topic, and so not surprisingly, news of this study caused the Internet to erupt in debate. On the one side, you have the "I toldja so!" camp, and on the other, the naysayers who dismiss the findings as alarmist "junk science."
What, then, is the takeaway?
For starters, while the findings are no doubt troubling, depression is a serious and sometimes life-threatening condition, and women shouldn't just stop taking their medications because of one study. Espcially considering that Berard told The New York Times that the results show correlation, but not necessarily causation. "The causes of autism are still unknown," she said. "We studied one of multiple environmental causes and measured an association. It's not a cause."
We also spoke to Joanne Stone, M.D., director of Maternal Fetal Medicine for the Mount Sinai Health System, who told us that while the study may have been large in scope, it is by no means definitive. "Overall, It's a good study and raises important questions, but more studies need to be done," she said. "They used data from prescriptions that were filled, but we really have no idea if the patients actually took the medications. It's a fairly reliable assumption, but it is a limitation of the study."
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Still, there's no denying the results sound scary—especially when you take into consideration the fact that 14 to 23 percent of women experience depressive symptoms while pregnant—so it's not difficult to see why a mother-to-be who is currently taking SSRIs might be feeling a little freaked out.
Even so, Dr. Stone says the decision to forgo your meds should not be taken lightly. "The majority of women who go off their antidepressants do relapse and need to restart their medications," she said. "Depression has been associated with a higher risk of pregnancy complications as well."
Alan Manevitz, M.D., an attending psychiatrist at NewYork-Presbyterian and Lenox Hill Hospitals in New York, agrees that pregnant women taking SSRIs should not panic and discontinue their medication. "They could go through withdrawal symptoms that could be a higher risk than continuing on their medicine," he says.
When untreated, depression can have a serious impact on both the mom-to-be and her unborn baby. "Untreated depression can lead to poor maternal care (poor diet, not taking prenatal vitamins, missing doctor's appointments, lack of exercise) or other risky behaviors (smoking, alcohol, street drugs as a form of 'self-medication')—all actions that can potentially lead to miscarriages, early birth, low birth weight, and other consequences," Dr. Manevitz says. "Untreated depression can also wreak havoc on families and other children and increase the risk of postpartum depression, which can interfere with bonding and caring for the newborn infant."
How, then, should pregnant women in need of SSRIs even begin to decide on a course of action? ""They should consult their obstetrician and psychiatrist before deciding anything," Dr. Manevitz urges. "Every pregnancy needs to be considered individually for the risk benefit of treatment."