28 August 2014

Antidepros during pregnancy raise ADHD risk in kids

The use of antidepressants by women during pregnancy may heighten the risk of attention-deficit/hyperactivity disorder (ADHD) in their children.

There's been controversy for years over whether the use of common antidepressants by women during their pregnancies might raise the odds of mental health issues in their children.

Now, a study involving more than 13,000 children finds no rise in the risk of autism in children whose mothers used an antidepressant while pregnant, but some data suggests a heightened risk of attention-deficit/hyperactivity disorder (ADHD) in these youngsters.

The findings challenge prior research pointing to a link between exposure to antidepressants in the womb and a greater risk of autism. Instead, severe maternal depression may be the risk factor boosting a child's odds for autism – not any antidepressant a woman took during her pregnancy, the new study's authors said.

"We know that untreated depression can pose serious health risks to both a mother and child, so it's important that women being treated with antidepressants who become pregnant, or who are thinking about becoming pregnant, know that these medications will not increase their child's risk of autism," study senior author Dr. Roy Perlis, of the department of psychiatry at Massachusetts General Hospital in Boston, said in a hospital news release.

Severity of mothers' depression

In the new study, Perlis and colleagues analysed data from thousands of children with either an autism spectrum disorder or ADHD and thousands more children without either disorder. In total, they looked at the antidepressant use of mothers of 1,400 children diagnosed with an autism spectrum disorder and 4,000 kids without the condition. The team did the same for 2,250 youngsters with ADHD and 5,600 without.

Initial results suggested that taking antidepressants during pregnancy did increase the risk of both autism and ADHD in children. However, after the researchers adjusted the data for the severity of the mothers' depression, the link between antidepressants and autism became insignificant.

Read: Antidepressants may increase diabetes risk

However, even after adjusting for depression severity among mothers, the link between antidepressants and ADHD risk was still there, the study authors said. But because the study simply looked at past data, it could only point to an association, it could not prove cause and effect.

Treating depression important

One psychiatrist believes the findings highlight the importance of treating women with depression, even during their pregnancy.

"Up to one in five pregnant women suffer from depression, and the risks to them include prematurity, low birth weight, pre-eclampsia, postpartum depression and suicidality," said Dr. Deepan Singh, a child, adolescent and adult psychiatrist at Winthrop-University Hospital in Mineola, New York.

"Left untreated, these women are more likely to have relapses of depression as well as engage in high-risk behaviours such as substance abuse," he added.

Read: Married women have positive pregnancy

The new study "gives hope and confidence to the multitudes of suffering women who have feared the possibility of autism developing due to prenatal exposure to antidepressants," Singh said. "In fact, the article demonstrates that treatment might lower this risk."

More research needed

While decisions around how to treat depression are best left to a discussion between a woman and her physician, Singh believes that, overall, "the risks of untreated depression outweigh the possibility of harm from treatment."

Dr. Andrew Adesman is chief of developmental and behavioural paediatrics at Cohen Children's Medical Centre of New York, in New Hyde Park, New York. He also called the study "reassuring" for women worried about the potential for autism in their children. And Adesman said that the finding on ADHD risk "needs to be studied further to be sure that it is not a research artefact caused by some confounding variable."

Read: Low pregnancy weight may indicate autism

As for study author Perlis, he reminded women that "there are a range of options – medication and non-medication – for treating depression and anxiety in pregnancy. But if antidepressants are needed, I hope parents can feel reassured about their safety."

Read more:
Are antidepressants overused?
Antidepressants linked to bleeding risk
Will antidepressants affect my libido?

Image: Pregnant woman taking pills from Shutterstock

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation ( She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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