SSRIs

SSRIs during pregnancy can affect brain activity in babies

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Structured neurological and behavioural assessments showed only minor differences, but EEG assessments exhibited several differences.

Taking a specific group of antidepressants, namely selective serotonin reuptake inhibitors (SSRIs), during pregnancy can affect brain activity in newborns. This is the result of a Finnish study published in “Cerebral Cortex”.

The study, carried out by scientists at the University of Helsinki, included 22 pregnant women who took SSRIs and 62 controls without medication during pregnancy. They assessed to what extent the mothers’ psychiatric symptoms and the medication affected the newborn’s neurological development and brain activity.

While structured behavioural and neurological tests indicated only minor effects of SSRIs, EEG scans however found several differences between the study and the control group. For instance, the communication between the brain hemispheres was less organised and the cortical rhythms exhibited a weaker synchronisation.

However, researchers stressed that the extent of maternal depression was not associated with these differences. This confirms that the effect is caused by the medication. The researchers therefore conclude that pregnant women with depression who take SSRIs should be closely monitored or treated without SSRIs. Recent studies have provided promising results of group therapy in treating depression and anxiety during pregnancy.

Depression may impair fertility

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Study: Severely depressed women have a lower chance of becoming pregnant. Medication does not appear to be the cause.

Severe depression seems to impair fertility – regardless of treatment with psychotropic medication. This is the outcome of a study carried out by US researchers published in the “American Journal of Obstetrics & Gynecology”.

More than 2,100 women aged between 21 and 45 years who planned to become pregnant participated in the study carried out by researchers at Boston University (Massachusetts). The scientists examined factors that may impair fertility. Participants were asked to report their current depressive symptoms and use of psychotropic medications. Of these women, 22 per cent reported to have been clinically diagnosed with depression at some point in their medical history. 17.2 per cent were former users of psychotropic medications, and 10.3 per cent were current users of these medications.

According to the results, women with severe depressive symptoms were 38 per cent less likely to become pregnant in a normal menstrual cycle compared to participants with no or low symptoms of depression. It made no difference whether or not those affected had taken psychotropic medications.

In addition, the results showed that taking benzodiazepines led to a decrease in fertility. In contrast, earlier treatment with SSRIs (selective serotonin reuptake inhibitors) increased the chance of conception. However, absolute numbers of those affected were too small; further trials are therefore needed.

The underlying reasons for the association between depression and fertility are still unknown. There are several potential mechanisms, but they still need to be studied further. This includes the fact that depression has been associated with dysregulation of the hypothalamic-pituitary-adrenal axis, which may have an impact on the menstrual cycle and impair fertility.

Taking SSRIs during pregnancy could result in depression in teenagers

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Rate of depression at age 15 reached 8.2 per cent while it was only 1.9 per cent in children of mothers who did not take SSRIs.

Taking a specific class of antidepressants during pregnancy could result in the offspring being more prone to developing depression. Selective serotonin reuptake inhibitors (SSRIs) increase the risk of children developing depression during adolescence, according to a Finnish study published in the “Journal of the American Academy of Child and Adolescent Psychiatry”.

For their study, scientists at the universities of Helsinki and Turku and Columbia University in New York (USA) drew on a national Finnish registry. They analysed data from 16,000 women who had taken SSRIs during pregnancy between 1996 and 2010. Children born to this group of mothers ranged between zero and 15 years and were examined for autism, psychiatric diagnoses, anxiety and ADHD. In order to exclude that the children’s disorders may be attributed to maternal psychiatric illness, the cohort was compared with children from healthy mothers and from depressive mothers who did not take SSRIs.

Children exposed to SSRIs were found to have a higher risk of depression at age twelve, with the cumulative incidence reaching 8.2 per cent at age 15. In the control group of children with depressive mothers who did not take SSRIs, only 1.9 per cent had symptoms of depression. Rates of ADHD and autism spectrum disorder were similar in children with depressive mothers regardless of medication use. However, compared with children of healthy mothers, all diagnoses of psychiatric illnesses were significantly higher in children exposed to SSRIs.

Studies are now needed to determine in which stages of pregnancy the foetus may be sensitive to the medications and if some drugs are safer than others, say the researchers. They noted that psychotherapy may possibly be a means to maximise the benefit for the mothers while minimising the risk for their children.

Study: autism-risk caused by antidepressants taken during pregnancy

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Data analysis of 145,456 pregnancies indicates a higher risk of 87 per cent.

A comprehensive study once again confirms an increased risk of autism caused by taking antidepressants during pregnancy. According to Canadian researchers who published their results in “JAMA paediatrics”, the risk is increased by 87 per cent.

Scientists from the University of Montreal and CHU Sainte-Justine analysed data from 145,456 children who were observed from the time of their conception up to their tenth birthday. In addition to information about the mother’s use of medication (including antidepressants) and the diagnosis of autism, several additional factors were measured and taken into consideration.

Autism was diagnosed in 0.72 per cent of children (1,054) on average at 4.5 years of age. If the mother had taken antidepressants – in particular, selective serotonin reuptake inhibitors (SSRIs) – during the second or third trimester of pregnancy, the autism risk or that of a similar disease (Asperger’s syndrome, atypical autism, pervasive developmental disorder) was 87 per cent higher.

“It is biologically plausible that antidepressants are causing autism if used at the time of brain development in the womb. Serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neurons, cell differentiation and synaptogenesis”, explained study leader Anick Berard. Drugs that inhibit serotonin may therefore have a negative impact on brain development.