Antidepressants are big business in the US, and according to a recent CDC report, 10% of Americans over age 12 now taking at least one antidepressant. Many people are taking more than one, and women are 2-1/2 times more likely to be using them than men. Women are also more likely to be taking antidepressants at all levels of depression severity. So a women with mild depression is more likely to be medicated than a man with the same symptoms.
The high rate of use by women could be having unintended consequences. Reports last summer hinted at a link between Autism Spectrum Disorder (ASD) and use of anti depressants during pregnancy. One study compared autism incidence in children to the mother’s use of an antidepressant during pregnancy. The researchers concluded that there was a link, with the risk of autism doubling with antidepressant use. However, but the authors believed the overall risk was only modest, and not a major cause of autism. Exposure through breast milk, or the mother’s depressive state could also contribute. Another study looked at twins and autism, and concluded that environmental factors, not genes, accounted for more than half the risk for autism. What counts as an environmental factor? The environment in utero is critical, especially for brain development, which peaks during the third trimester. However, this study didn’t identify any specific environmental issues that would increase risk for autism.
A new study is raising more concerns about antidepressant use in pregnancy. This study looked at the effect of various antidepressants on rat pups, which were dosed with the drugs after birth, at a developmental state similar to the third trimester for a human fetus. The pups were put through various rat behavior tests, such as play and response to an unusual object or sound. Results: exposure to the SSRI class of antidepressant drugs significantly altered the rats’ behavior, in ways that mimic autism behaviors in children. This effect was more pronounced for male rats. Conclusion:
… neonatal exposure to antidepressants in rats results in sensory and social abnormalities that parallel many of those reported in ASD.
Of course, other medical providers can argue with a conclusion based on rat studies, but it does raise concerns. Women are more likely to be prescribed antidepressants, and according to the CDC report, fewer than 1/3 of people on the drugs had consulted with a mental health professional during the previous year. In other words, they’re just taking pills, and not using other methods of dealing with depression, such as psychotherapy.
Women who are of child bearing age and using antidepressants should certainly discuss their medications with their physicians before becoming pregnant. This is important, as one study suggested a link to use in the first trimester and ASD risk. Treatment of depression in the mother needs to be weighed against possible risk to the fetus. Future research may help clarify whether or not some antidepressant drugs pose less risk.