Antidepressants associated with autism.
Croen, LA, JK Grether, CK Yoshida, R Odwouli and V Hendrick. 2011. Antidepressant use during pregnancy and childhood autism spectrum disorders. Archives of General Psychiatry http://dx.doi.org/10.1001/archgenpsychiatry.2011.73.
Mothers who took selective serotonin reuptake inhibitors (SSRIs) – the most commonly prescribed antidepressants – during the year before delivery or during the first trimester of pregnancy were at increased risk to have a child with an autism spectrum disorder (ASD). Researchers identified a two-fold increased risk of autism in children of mothers who took SSRIs during the year before pregnancy and a nearly four-fold risk for those who took them during the first trimester of pregnancy.
The study is important because it provides the first look at the relationship between SSRI use and autism risk. While other research has identified depression in the mother as a risk factor for autism, the relationship of treatment for depression and autism is yet unexplored.
The ASDs are a group of neurodevelopmental disorders that affect about 1 in 150 U.S. children, according to the Centers for Disease Control and Prevention. Generally, children with ASDs exhibit social and intellectual shortcomings that fall within a wide range of symptoms and severity. Rates have risen rapidly but exact causes are still unkown. While genetic factors have been frequently examined, recent research suggests that environmental risk factors may be important as well.
Researchers from Kaiser Permanente in Northern California examined the medical records of 289 mother-child pairs where the child was diagnosed with an ASD and 1,507 mother-child pairs where the child had not been diagnosed with an ASD. Using data from pharmacy prescription records and medical records, the authors determined the number of mothers who received a prescription for an SSRI or other anti-depressant – and more importantly – when the prescription was issued relative to their pregnancy.
A two-fold increased risk of ASD was found among children who had mothers that took an SSRI the year before delivery. Additionally, the authors identified an increased risk of ASD in children who had a mother treated with an SSRI during the first trimester of pregnancy. Since a history of maternal depression has been associated with autism risk in previous work, the authors included both information on maternal depression and other psychiatric illness in their analyses, which did not change these relationships.
The authors also looked to see if severity of psychiatric illness – measured by hospitalizations, number of SSRI prescriptions or supply of SSRIs – was associated with autism among those mothers reporting SSRI use in the year before delivery. No clear relationships with severity were identified.
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