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Scientists Link SSRI Antidepressants to Brain Structure Birth Defect

May 20, 2014

Scientists at the University of North Carolina at Chapel Hill have found that women who take SSRI antidepressants during pregnancy dramatically increase the risk that their children will be born with an abnormal brain structure known as a Chiari I malformation. The findings were published online on May 19, 2014 in the journal Neuropsychopharmacology in advance of print publication.

Chiari I malformations are present at birth but symptoms, including headaches, ocular disturbances (of our connected to eyes or vision), hydrocephalus (fluid accumulation in the brain), and spinal cord damage, may not be noticed until adolescence or adulthood. The malformation is located at the back of the head where the spinal cord and skull connect. Surgery is often required.


"We found a striking increase in CIM in children with prenatal SSRI exposure."


The researchers compared the children of women who took SSRI antidepressants during pregnancy with with children who had no exposure to maternal depression or SSRIs. To examine the possible influence of maternal depression in the absence of SSRI treatment, children who were exposed to SSRIs were also compared to a second group of children whose mothers had a history of depression but did not take SSRIs during pregnancy. All the children received structural MRI scans.

Children who were prenatally exposed to SSRI antidepressants were 10 times more likely to have Chiari I malformations than children who were not exposed to maternal depression or SSRIs. However, the children of mothers with a history of depression who did not take SSRIs "did not differ from comparison children with no history of depression and no SSRI exposure in occurrence of CIM." CIM was also found to be "more common in children with longer duration of SSRI exposure," another indicator that SSRIs, not depression, are responsible for the findings.

The investigators also found several other indicators of SSRI-linked effects. The SSRI-exposed babies were born earlier, were shorter in length, and had longer stays in the neonatal intensive care units.

While the exact cause of CIM is unknown, the authors of the study note that most theories trace the origins of CIM to early fetal development. They write that serotonin, the neurotransmitter most affected by SSRI antidepressants, "plays a critical role in craniofacial development, making a causal pathway from SSRI exposure to CIM theoretically plausible." SSRIs have been linked to a number of other birth defects and autism – conditions that are also believed to originate in early fetal development, a time during which serotonin is known to play a critical role.


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