Babies born to mothers who took
antidepressants early in their
pregnancy are approximately three
times more likely to develop autism.

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Antidepressants and Autism: Time to Worry, Says Expert

February 1, 2014

Fetal medicine specialist, Dr. Adam UratoThe drug safety website has published a review of the current state of knowledge regarding autism and antidepressants by Adam Urato, a fetal medicine specialist at Tufts Medical Center in Boston, Massachusetts, and the Chairman of Obstetrics and Gynecology at MetroWest Medical Center in Framingham, Massachusetts.  Dr. Urato discusses the scientific basis for concerns that SSRI antidepressants may disrupt the normal development of the fetus and lead to "neurodevelopmental abnormalities - including autism."

SSRI antidepressants have been linked to a number of birth defects and pregnancy complications and it is believed that their effects on the neurotransmitter serotonin may be responsible. Serotonin is known to play a critical role in brain formation and it has been discovered that one of the primary features of autism is an imbalance in the body's serotonin system.  Several animal studies have shown changes in the brains and behavior of animals exposed to SSRIs during development.

Human studies have revealed a wide range of adverse cognitive effects on children who were exposed to SSRIs during pregnancy. These include delays in reaching gross motor milestones (e.g., sitting, walking), lower scores in tests of gross motor skills, impacts on social and emotional functioning, and biological indications of possible brain damage.

Dr. Urato builds his case persuasively. After demonstrating that there is a reasonable mechanism by which SSRIs could disrupt fetal development and reviewing the evidence that such disruptions do indeed occur, he moves to the scientific literature linking SSRIs to autism. Two studies have found that women who take SSRIs at least double, and possibly triple or quadruple, the risk that their children will be autistic. Both studies indicated that maternal depression, without exposure to SSRIs, was not linked to autism.

Two more recent studies appeared to suggest that some factor common to women who take SSRIs was causing the apparent increased risk, but Dr. Urato shows that both studies may have underestimated the risk and are open to an interpretation that puts their findings squarely in agreement with the two earlier studies.

When it comes to taking SSRIs, the risks far outweigh the benefits, says Dr. Urato. "Sadly," he writes, "in 25 years of study, not a single study has ever shown improvements in pregnancy outcomes in the antidepressant-treated group."  His article answers the question posed in its title: "Antidepressants and Autism: Time to Worry?"  Clearly it is.

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