In the U.S., doctors give antidepressant drugs to between 7 and 13 percent of pregnant women. But there is a good reason doctors are always cautioned not to prescribe drugs for pregnant women. Especially when you consider the results from a brand new study published in Pediatrics, the official journal of the American Academy of Pediatrics.
This powerful study found a strong association between the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and autism spectrum disorder (ASD) and developmental delays (DD) in children.
The new study looked at 1,000 mother-child pairs. The researchers evaluated the mothers for their use of alcohol, nicotine, and illicit drugs during pregnancy. They also evaluated the mothers’ use of prescription drugs. Including SSRI antidepressants and non-SSRIs, such as tricyclic antidepressants.
They found that 48 women (about 5 percent of all mothers) took an SSRI antidepressant during pregnancy. Among them, 44 percent took fluoxetine (Prozac), 21 percent took seratraline (Zoloft), 19 percent took paroxetine (Paxil), and 16 percent took citalopram/escitalopram (Celexa/Lexapro).
The researchers linked maternal SSRI use with a markedly increased risk of both ASD and developmental delays in boys. (There were far fewer girls in the study and results were not statistically significant.)
They found boys with autism were nearly three times more likely to have had fetal exposure to SSRIs than those without autism. The strongest risk was among those exposed during the first trimester.
In addition, boys with developmental delays were more than three times as likely to have had fetal exposure to SSRIs. That connection was strongest among boys exposed to an SSRI in the third trimester.
Of course, the researchers made the “ritual call” for more research. And they said we should weigh the potential harms of these drugs against the potential benefits for maternal depression.
But that caution assumes there are benefits to taking these drugs. Of course, the researchers did not prove or address these supposed benefits in their report. They just assumed we all accept the “proven” benefits to SSRIs.
But as you know, SSRIs help only about one in seven patients who take them. Plus, there is finally dawning awareness in the medical community that SSRIs actually cause suicide. In fact, many experts now question whether these known risks outweigh the limited benefits for anyone taking these dangerous drugs.
But back to this most recent study…
Ten years ago, the FDA made changes to the drug labeling for SSRIs. And they called into question the safety of exposing children in the womb. Nonetheless, fully one-third of the mothers in this study were prescribed SSRIs after the FDA put the new warnings into place.
But then again, what does another run-of-the-mill FDA warning mean to doctors?
Truly, we shouldn’t need the FDA to weigh in on the issue. There has long been a cardinal rule not to give drugs to pregnant women.
Doctors who break this cardinal rule with SSRIs put their patients in peril… and their patients’ children in peril as well.
1. “Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay,” Pediatrics, originally published on-line April 14, 2014
2. “Use of antidepressant medications during pregnancy: a multisite study,” Am J Obstet Gynecol 2008;198:194.e1–194.e5