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Study links antidepressant use during pregnancy to higher ADHD risk

Scary studies linking antidepressant use during pregnancy with an increased autism risk in babies may have scared some pregnant women off of the medications, but a new Massachusetts General Hospital study provides some comforting news. The heightened autism risk associated with antidepressant use is likely due to the severity of the depression itself, rather than the medications.

“Women with a major depressive disorder need to be reassured that continuing these drugs during pregnancy won’t expose their fetus to an increased risk of autism,” said study co-author Dr. Roy Perlis, director of the center for experimental drugs and diagnostics at Massachusetts General Hospital.


But the study did find an alarming 80 percent increased risk in attention deficit hyperactivity disorder that was associated with a child’s exposure to antidepressants in the womb. Perlis emphasized that this was a “preliminary finding” that needed to be replicated in future studies.

The study was funded by the National Institute of Mental Health, but Perlis and several study co-authors disclosed that they received consulting fees from pharmaceutical companies that make antidepressants.

Conducting a clinical trial of antidepressant use during pregnancy — where women are randomly assigned to take the medications or placebos — wouldn’t be ethical, so researchers are left to cull through medical records to try to determine whether a mother’s mental illness or medication use during pregnancy may have played a role in her child’s subsequent development of autism or ADHD.

In the study published Tuesday in the journal Molecular Psychiatry, MGH researchers examined anonymous electronic medical records from Partners HealthCare comparing 1377 children diagnosed with autism and 2243 diagnosed with ADHD with a group of children without any behavioral disorders. They also examined the mother’s medical records and found that those diagnosed with depression or any mental illness were 45 percent more likely to give birth to a child who later developed autism regardless of whether they took antidepressants during pregnancy.


Dr. Adam Urato, a maternal-fetal medicine specialist at Tufts Medical Center and Metrowest Medical who has conducted research on antidepressant use during pregnancy, said he’s worried that the researchers “spin” on the study findings has minimized the risks that these drugs pose to developing fetuses.

“This isn’t rocket science,” Urato said. “When we expose the developing fetal brain to synthetic chemical compounds, we should expect to see neurobehavioral abnormalities and that is exactly what the studies keep showing.”

Perlis emphasized that the latest finding doesn’t provide “definitive answers” concerning prenatal antidepressant risks but that it underscored the importance of women talking with their doctors about their own personal risks before deciding whether to stay on or go off the medications during pregnancy. A 2006 study found that women who went off antidepressants during pregnancy had a five times greater risk of relapse of their depression.

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.