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New Study Links Autism with Antidepressant Use
During Pregnancy
A new study, first published online April 19, 2013, looked at drug use during pregnancy by Swedish mothers over a six year period (2001-2007) and found "an association between in utero exposure of babies to antidepressants and an increased risk of autism spectrum disorders, particularly without intellectual disability."
 Though the authors could not definitively rule out the impact of maternal depression itself on autism risk, they stated that evidence for the commonly held belief that depression confers an increased risk of autism "is relatively weak," referencing two meta-analyses (studies that analyze the results of several studies) that addressed this question whose results, they wrote, were "inconclusive." A recent U.S. study found that there was no increased risk for mothers with a history of mental health treatment as long as the fetus had not been exposed to SSRIs.
The researchers reported that it was not just selective serotonin reuptake inhibitors (SSRIs), drugs like Prozac, Paxil, Celexa, and Zoloft, that may confer the increased risk. Non-SSRI antidepressants were also associated with the increased risk, though the authors noted that "almost all other antidepressants have serotonergic activity" – i.e., they also affect serotonin, a chemical neurotransmitter that is found throughout the body and brain.
This is important, according to the authors, because serotonin is known to be "involved in critical neurodevelopmental processes" in the developing fetus and exposure to SSRIs in the uterus has been shown to change brain circuitry and lead to behavioral changes similar to autism in animals.
Summary Information
Title
Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study
Authors
Dheeraj Rai, clinical lecturer 1,2,3; Brian K Lee, assistant professor 4; Christina Dalman, associate professor 2; Jean Golding, professor emeritus 5; Glyn Lewis, professor 1; Cecilia Magnusson, professor 2
- Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Avon and Wiltshire Partnership Mental Health NHS Trust, Bristol, UK
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
Journal
British Medical Journal 2013;346, f2059. First published online April 19, 2013
Funding
This study was funded by the Swedish Research Council (grant No 2012-3017). The data linkages and staff costs have also been supported by grants from the Stockholm County Council (2007008), Swedish Council for Working Life and Social Research (2007-2064), Swedish Research Council (523-2010-1052), and Swedish Regional agreement on medical training and clinical research (ALF). No funder had any role in the study design; data collection, analysis, or interpretation; in the writing of the report; or in the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of any of the funders or organizations they represent.
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