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Antidepressants may cause birth defects, but not ADHD, autism

Research on the effects of antidepressants on pregnancy, however, has been inconsistent and shown a range of potential outcomes after using the drugs.
By Stephen Feller   |   Jan. 6, 2016 at 9:47 AM

WASHINGTON, Jan. 6 (UPI) -- Treating women with depression and related conditions during pregnancy is important for both the mother and baby. Recent studies into the effects of antidepressants on babies, before and after they are born, have been inconsistent, however.

Two studies out this week show that while there is no increased risk for autism or attention deficit hyperactive disorder, at least one drug used for depression -- paroxetine, or Paxil -- can increase the risk for heart defects if taken during the first trimester.

Nearly one-fifth of women experience depressive symptoms during childbearing years, with prescriptions of antidepressant drugs increasing in recent years for treatment, researchers said.

"Taking any medicine during pregnancy can be a difficult decision," said Dr. Roy Perlis, an associate professor of Psychiatry at Harvard Medical School, in a press release. "While there are depression treatments that don't involve medication, for some patients they are not effective, available or preferred. We want women and the clinicians working with them to be as informed as possible when making this decision."

In a study at Harvard, published in Translational Psychiatry, researchers compared data on 1,245 children with an autism spectrum disorder and 1,701 with ADHD and their mothers to child-mother pairs with no neurophychiatric diagnoses.

The researchers found the incidence of both disorders was higher in the children of mothers who took antidepressants before getting pregnant, but that use during pregnancy did not appear to increase the risk.

Like another study published in 2014 by the same research team, three studies published in 2015 found similar evidence that the drugs themselves did not increase the chances for either disorder. The bigger risk, they said, was untreated depression in the mothers.

A research team at the University of Montreal reported last year, however, the children of mothers who use selective serotonin reuptake inhibitors, or SSRIs, for depression during the second and third trimesters of pregnancy have an increased chance of autism.

The same researchers at the University of Montreal also found in a recent study that the SSRI paroxitine, or Paxil, has a significant effect on the chance of children being born with heart defects.

In the study, published in the British Journal of Clinical Pharmacology, researchers reviewed 23 studies published between 1966 and 2015 that included major cardiac malformations in the infants of mothers treated with the drug.

Mothers who used paroxetine during the first trimester of pregnancy were linked to a 23 percent increase in major congenital malformations in their infants and a 28 percent chance of major cardiac malformations. The typical risks are 3 percent and 1 percent.

While researchers point out the consequences of not treating depression can be just as negative, the risks involved with using antidepressants should be considered before including them in any treatment.

"Given that the benefits of antidepressants overall, and selective serotonin reuptake inhibitors including paroxetine specifically, during pregnancy is questionable at best, any increase in risk -- small or large -- is too high," Dr. Anick Bérard, a professor at the University of Montreal, said in a press release. "Indeed, the risk/benefit ratio suggests non-use in women with mild to moderately depressive symptoms, which is 85 percent of pregnant women with depressive symptoms. Therefore, planning of pregnancy is essential, and valid treatment options such as psychotherapy or exercise regimens are warranted in this special population."

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