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Prenatal exposure to antidepressants, antipsychotics not linked to autism risk

By Allen Cone
A study found that a mother's prenatal use of antidepressants and antipsychotics was not associated with a higher risk of autism spectrum disorder in her children. Photo by nickelbabe/Pixabay
A study found that a mother's prenatal use of antidepressants and antipsychotics was not associated with a higher risk of autism spectrum disorder in her children. Photo by nickelbabe/Pixabay

Oct. 31 (UPI) -- A mother's use of antidepressants and antipsychotics during pregnancy is not associated with a higher risk of autism spectrum disorder in her children, according to a study.

Researchers studied the prenatal the effects of drugs that target neurotransmitters among 96,249 individuals -- 1,405 cases of autism and 94,844 without -- from a large health maintenance organization in Israel, where all citizens are required to purchase a medical insurance plan.

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The findings were published Wednesday in JAMA Psychiatry.

"We wanted to know whether medication during pregnancy could affect the offspring," corresponding author Dr. Magdalena Janecka, a professor in the Department of Psychiatry at the Icahn School of Medicine at Mountain Sinai Health System in New York, said in a JAMA podcast. "We basically found that children exposed to medication were not more likely to develop autism than non-exposed children."

But she noted they observed a higher rate of autism in children from mothers with more medical problems.

Autism, which develops in childhood and continues through adulthood, is a neurological and developmental disorder. It can cause issues with social skills, repetitive behaviors and speech and nonverbal communication.

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Researchers do not know the exact cause of autism, but theories include heredity, genetics and medical problems, according to Autism Society. Researchers have been investigating pregnancy or delivery problems, as well as environmental factors that include viral infections, metabolic imbalances and exposure to chemicals.

The prevalence of autism is 1 in 59 children in the United States, according to a study by the Centers for Disease Control and Prevention.

Researchers in the new study found mothers exposed to the drugs would have on average a 1.38 percent chance of having a child with ASD, compared with the 1.1 percent baseline.

"The perception of risk can still have implications on the clinical practice, discouraging physicians from prescribing those medications to pregnant women," Janecka said.

Of 34 groups of medications, five showed a nominally statistically significant association with ASD in fully adjusted models.

Two medication groups in the sample that had high association treat epilepsy -- valproate, which is involved in the neurotransmitter's breakdown, and antagonists of the neuronal nicotinic acetylcholine receptors.

Lower risks were associated with cannabinoid receptor agonists and opioid receptors.

"Our research does not fully resolve those issues and have a very long way to go," Janecka said. "To avoid women terminating medication, we really need to look at the causal relationship."

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In an accompanying editorial, Drs. Diana Schendel, Jakob Christensen and Dheeraj Rai said the study "is intriguing and warrants careful consideration."

But they noted the findings have pitfalls.

"It would be hasty to conclude, based on this study's negative findings for specific drug classes, that drugs in the class have no associations with autism because there may be other mechanisms at play," they wrote. "Further, it is important to recognize that a full profile of the pharmacological properties of many of the drugs examined in this study is still unknown."

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