Home > Got Questions?, Science > I see more headlines about autism risk and antidepressants in pregnancy. What am I supposed to do?

I see more headlines about autism risk and antidepressants in pregnancy. What am I supposed to do?

This week’s ‘Got Questions?’ answer comes from Rob Ring, PhD, Autism Speaks vice president of Translational Research, and Joe Horrigan, MD, Autism Speaks assistant vice president, head of medical research.

To bring readers up to speed, the above question stems from two reports: In July, a group of California researchers reported a modest increase in the risk that a child would develop autism if his or her mother took selective serotonin uptake inhibitors (SSRIs) during pregnancy. The results were based on a very small sample of children exposed to antidepressants during the time their mothers were pregnant—just 20 children with autism compared to 50 without autism. This past month, another team of scientists reported that rats fed SSRIs as newborn pups exhibited abnormalities in brain development.

Given the great hunger for information about what causes autism, both studies made headlines. Unfortunately, the media stories may have served to alarm without putting these early and inconclusive scientific findings into perspective.

First and foremost, research with animals and investigations looking at a small number of cases are both important for guiding larger, more informative studies. But in and of themselves, these two particular studies don’t come close to reaching the bar at which scientific evidence is reliable enough to warrant a change in behavior. We feel this is particularly true of important medical decisions such as the need to treat depression, which can be a serious and life-threatening illness.

Take, for instance, the small number of children in the California study. This small “sample size” increases the likelihood that the results were due to chance or other unrelated factors. In other words, they may not represent real differences in risk. It is very common in science for such preliminary findings to vanish when researchers repeat the analysis with a larger, more “statistically significant” number of cases.

In addition, among women taking SSRIs, there may be other, hidden factors responsible for raising autism risk among their future children. For example, we know that anxiety is common among persons with an autism spectrum disorder (ASD). In fact, many of those who learn, as adults, that they have an ASD do so when they seek treatment for anxiety and/or related depression. A common type of medicine prescribed in these instances is SSRIs. We also know that ASDs tend to run in families. So it may be that family genetics—not SSRIs—produced the above-mentioned finding of a modest increase in the prevalence of autism among children whose mothers took these antidepressants during pregnancy.

And the rat study? While it’s useful for guiding the focus of further research, we simply can’t extrapolate results from rats to humans.

Finally, we worry about the consequences of women going off antidepressants when they truly need these medications. Certainly if a woman is pregnant or trying to become pregnant, she should discuss all her medicines with her physician—so that with guidance she can weigh the risks and benefits of continuing or discontinuing one or more of them. Certainly, a woman’s untreated depression can itself pose a danger to her pregnancy or newborn child. The bottom line:  If you have concerns regarding your medications during pregnancy, discuss them with your physician, who can help you make the best decision for you and your family.

We hope that we’ve lent some helpful perspective to this issue. Please keep your questions coming (GotQuestions@autismspeaks.org).

  1. November 4, 2011 at 2:17 pm

    My son was diagnosed with Autism/adhd and his kumon teacher introducted me to a natural product made from milk after its production it is the closest to Mothers Milk. 30 years of research have gone into this product by Scientist and DRS. I tried it and in 2 months I saw results. Today is son shows no sign of Autism/adhd doing tremendously, focused on his school work and takes the initiative to do everything for himself, truly a turnaround from the way he used to be. If you are interested to find out more, please email me at asha.persaud@gmail.com. Thanks

  2. November 5, 2011 at 3:01 am

    Depression can be treated naturally, using Omega-3 fats found in fish oil. Just take the proper dose! Make sure to get 1200-1400 mg of EPA daily (in 2 divided doses). Read the back of the label for EPA content, and note number of pills per serving.

    Don’t believe this? Then google “crooked receptors” You will see info about how the brain is made from fat, (ie: Omega-3 fat, from fish oil). The brain has serotonin receptors. You can take all the SSRI (serotonin reuptake inhibitors) till the cows come home. But if you don’t have enough omega-3 fat (from fish oil), then the receptors shift and become “crooked.” Then the brain can’t use the serotonin nearly as well and then people get very, very depressed.

    You have nothing to lose by trying to take 12-1400 mg of EPA in the fish oil. You will notice a small difference in about a week, a huge difference in about 3 weeks. Try it, see for yourself how you feel.

  3. Monica
    November 5, 2011 at 10:40 am

    Is cortical dysplasia one of the brain abnormalities associated with SSRI use during pregnancy? I know that cortical dysplasia is one cause of epilepsy and epilepsy is a co morbid condition associated with ASD.
    Also, has any research been done using MRI’s to scan the brains of parents of children diagnosed with an autism spectrum disorder? Our brain anatomy is more defined due to the fact we are fully grown. Common structural abnormalities may be identified.

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