This column originally appeared in the Daily Telegraph.
Note to readers: Abruptly stopping the use of medication can carry risks. Always seek medical advice before starting or ceasing any medicines, especially during pregnancy.
Mothers who use antidepressants during pregnancy could be increasing the risk their child will develop Attention Deficit Hyperactivity Disorder (ADHD).
A major new study published in the journal Molecular Psychiatry has found children whose mothers used antidepressants during pregnancy had almost double the risk of developing ADHD.
However, the study authors and other experts have warned expectant mothers not to stop their medication without talking to a doctor.
The risks for both mother and child must be considered
The risk of ADHD had to be balanced against maternal depression during pregnancy which has “health complications for both the mother and child”, the study says.
“Discontinuation of antidepressants during pregnancy can increase the risk of relapse five-fold,” the study warns.
The study looked at more than 1,300 children diagnosed with autism and 2,200 with ADHD and matched them with healthy control children.
It found antidepressant exposure prior to and during pregnancy was associated with a risk the child would develop autism but this was no longer significant when the study controlled for the effects of major depression.
However, it found an increased risk of ADHD in the child if antidepressants were used during but not prior to pregnancy.
The risk of ADHD was greatest if the antidepressants were used during the first three months of the pregnancy, the US researchers found.
The authors warn the weakness of the study is that it is possible it was confounded by the fact the mothers had depression in the first place.
More caution and more study needed
Professor of Women’s Health at Monash University, Jane Fisher, says Australian women prefer not to take any medications during pregnancy unless they are essential.
“Current psychiatric advice is generally that the risk of depression during pregnancy outweighs the risk of foetal exposure to antidepressant medication,” she says.
“These data challenge (sic) this assertion and suggest that great caution needs to be exercised in prescribing antidepressants to women who are pregnant or planning to be pregnant because of risks to foetal neuro-development,” she said.
Experts warn against ceasing medication or therapy
However, Professor Julie Quinlivan, Dean of Medicine at University Notre Dame, says suicide is a leading cause of maternal death in Australia and women should think hard before ceasing therapy.
“The consequences of suddenly stopping therapy may be drastic,” she said.
A Spanish expert Dr Celso Arango the director of the Spanish Centre for Biomedical Research in Madrid, said environmental factors were important in ADHD and warned about the controversy over the high levels of diagnosis of the problem in the US where a diagnosis is linked to extra school funding.
“This research does not mean that women should stop taking their antidepressants. It suggests that we need more animal and human research on how this drug affects the normal neurodevelopment of children,” he said.
The President of the European College of Neuropsychopharmacology, Professor Guy Goodwin, questions the credibility of the study.
“It remains possible, even likely, that the effect observed is due to increased genetic risks of psychiatric disorder in the offspring of the women prescribed antidepressants, rather than the effects of the drugs,” he says.
What do you think of these new findings? Did anti-depressants help you during pregnancy?
Read more on Kidspot:
- Managing the pregnancy blues
- A parent’s guide to ADHD
- Depression medication linked to heart defects in babies
- Study: Pregnant mums on antidepressants risk ADHD kids from news.com.au
- Link between use of anti-depressants during pregnancy and ADHD in kids from ABC Online
- Safety of antidepressants during pregnancy and breastfeeding from The Black Dog Institute