Antidepressants taken during pregnancy increase risk of autism by 87 percent

[LiberalArkie]

Researchers came to their conclusion after reviewing data from the outcomes of 145,456 pregnancies.

Anick Bérard: Using antidepressants, especially selective serotonin reuptake inhibitors (SSRI), during the 2nd/3rd trimesters of pregnancy increases the risk of having a child with autism (87 percent increased risk of autism with any antidepressants; more than doubling the risk with SSRI use specifically) – this risk is above and beyond the risk associated with maternal depression alone (maternal depression was associated with a 20 percent increased risk of autism in our study). Given the mounting evidence showing increased risk of adverse pregnancy outcome with antidepressant use during pregnancy, our study shows that depression should be treated with other options (other than antidepressants) during this critical period.

Indeed, 80-85 percent of depressed pregnant women are mildly to moderately depressed; exercise and psychotherapy have been shown to be efficacious to treat depression in this sub-group. Therefore, we acknowledge that depression is a serious condition but that antidepressants are not always the best solution.

RG: We normally think of the first trimester as being the riskiest time for the fetus, but this study was actually in the second and third trimesters. Why is the risk greater later in pregnancy?

Snip

https://www.researchgate.net/blog/post/antidepressants-taken-during-pregnancy-increase-risk-of-autism-by-87-percent

[saturnsring]

1. seems it was mother's little helper and not vaccines causing the problem

[digonswine]

2. That's not what mother's little helpers are-

depression is a real thing, you know.

Correct about the vaccines, though.

[nomorenomore08]

4. True. Think Seconal, Valium, etc., often prescribed to treat imaginary conditions.

Whereas anti-depressants are (generally) a different story.

[xmas74]

27. I worked in an institution for years.

Valium was often used and not to treat imaginary conditions.

[Warpy]

3. There are two massive growth spurts in neural development

The first is in the first 8 weeks of pregnancy, when the neural tube first forms. The second is in the third trimester, when brain structures are established and connections made (which is why early abortions are incapable of causing pain, the brain isn't really there yet which means the receptors for pain aren't). It would seem that whatever causes autism would be active in the second growth spurt. We know a folic acid deficiency can cause neural tube defects during the first.

[spinbaby]

5. Interesting

I have an autistic grandson, so I'm always interested in possible causes. It seems to me that the uptick in the use of SSRI drugs mirrors the epidemic of autism. Definitely worth further study.

[gitchel]

6. Yet another study blaming something that can be sued.

From the website at the University of Montreal:

"Dr. Bérard is the recipient of a FRQ-S research Chair on Medications and Pregnancy. Dr Bérard is a consultant for plaintiffs in litigations involving antidepressants and birth defects."

It's quite common for some schools to publish studies like this for money, or other advantage. We have a few like this in the states. For instance, UC Berkeley and the MIND Institute often publish studies that twist data around until it proves autism is caused by late-life pregnancies, power lines, old fathers, urban life or large highways. They get a lot of support from Autism Speaks, who hold the possibilities of cures out to their donors like a cartoon pie.

Autism is a genetic difference. There is no "cure." There is much that can be facilitated, managed, trained, mitigated or taught. But there is nothing to be cured.

Unfortunately, there's a lot more money to be scammed from frightened parents - or courts - if you can point at something as the cause. Especially if it's something widespread and poorly understood.

As for this study, I can't see where they've eliminated the probability that autistic children have one or more undiagnosed autistic parent. Such parents would be particularly susceptible to depression, and more likely than not treated with SSRIs.

I'm autistic. My mother had depression. However, she didn't get treatment until long after I was born.

I had depression and took SSRIs, but long after my children were born - at least one of them autistic. In fact, it's likely that my depression came from trying hard to be a good parent to three children before any of us were diagnosed. Though I suspect the data could be made to match autism to SSRIs if someone had interest in making a case against anti-depressants.

[pnwmom]

7. Identical twin studies show that autism isn't exclusively caused by genetic factors.

Both genetic and environmental causes play a role, with individuals differing in how how much their autism was influenced by genetic vs. environmental factors. Researchers now think that some people genetically were going to be autistic no matter what. Other autistic people might not have been autistic except for an environmental exposure. Others are in between, with genetic and environmental factors playing an equal role.

Autism is like bipolar disease and many other conditions in this respect. The condition is related to an interplay between multiple genetic factors and multiple environmental factors -- which makes the epidemiology very challenging.

https://www.ucsf.edu/news/2011/07/10153/study-debunks-autism-primarily-genetic-disorder

A rigorous study of nearly 400 twins has shown that environmental factors have been underestimated, and genetics overestimated, for their roles in autism-spectrum disorders.

The study found that the children’s environment represents more than half of the susceptibility — 55 percent in the most severe form of autism and 58 percent in the broad spectrum of the disorder — while genetics is involved in 37 percent and 38 percent of the risk, respectively.

This is the largest and most rigorous twin study to date to research the genetic component of the disorder, and tapped expertise from the UCSF Institute for Human Genetics and Stanford University — which jointly led the research — as well as from Kaiser Permanente, UC Davis, the Autism Genetic Research Exchange and the California Department of Public Health.

“Autism had been thought to be the most heritable of all neurodevelopmental disorders, with a few small twin studies suggesting a 90 percent link,” said UCSF geneticist Neil Risch, PhD, director of the UCSF Institute for Human Genetics and senior author of the paper. “It turns out the genetic component still plays an important role, but in our study, it was overshadowed by the environmental factors shared by twins.”

Findings appear in the July 2011 issue of the Archives of General Psychiatry.

[kcr]

8. That's how genetics works for pretty much everything

Look up epigenetics. Identical twins are not absolute copies of each other.

[pnwmom]

9. I understand that. And it is part of how environmental factors are involved.

Exposures to toxins in the womb can affect epigenetics.

[kcr]

10. Yes. But showing direct causal links is a different matter.

For example, why did one identical twin grow two inches taller than the other? Both twins come from the same womb. Most researchers would still tell you that height is a genetic trait. The point is the fact that environment affects genes doesn't automatically lend any credence to dubious links that are made.

[pnwmom]

11. I never said it was easy to show these links. But environmental factors are significant,

and underestimated, according to a major University of California S.F. study:

https://www.ucsf.edu/news/2011/07/10153/study-debunks-autism-primarily-genetic-disorder

A rigorous study of nearly 400 twins has shown that environmental factors have been underestimated, and genetics overestimated, for their roles in autism-spectrum disorders.

The study found that the children’s environment represents more than half of the susceptibility — 55 percent in the most severe form of autism and 58 percent in the broad spectrum of the disorder — while genetics is involved in 37 percent and 38 percent of the risk, respectively.

This is the largest and most rigorous twin study to date to research the genetic component of the disorder, and tapped expertise from the UCSF Institute for Human Genetics and Stanford University — which jointly led the research — as well as from Kaiser Permanente, UC Davis, the Autism Genetic Research Exchange and the California Department of Public Health.

“Autism had been thought to be the most heritable of all neurodevelopmental disorders, with a few small twin studies suggesting a 90 percent link,” said UCSF geneticist Neil Risch, PhD, director of the UCSF Institute for Human Genetics and senior author of the paper. “It turns out the genetic component still plays an important role, but in our study, it was overshadowed by the environmental factors shared by twins.”

Findings appear in the July 2011 issue of the Archives of General Psychiatry.

[kcr]

12. None of that means dubious links are automatically credible

That is my point. It also doesn't mean that genes don't lay the roadblock initially. If you don't have the inherited trait to begin with, there is no trait to switch on and off.

[pnwmom]

13. Who said they were? Do you disagree only with the words you put in my mouth,

or with what I actually said: "Both genetic and environmental causes play a role, with individuals differing in how how much their autism was influenced by genetic vs. environmental factors. Researchers now think that some people genetically were going to be autistic no matter what. Other autistic people might not have been autistic except for an environmental exposure. Others are in between, with genetic and environmental factors playing an equal role.

"Autism is like bipolar disease and many other conditions in this respect. The condition is related to an interplay between multiple genetic factors and multiple environmental factors -- which makes the epidemiology very challenging. "

[kcr]

14. Forgive me for misunderstanding. I thought you were defending the study.

It appeared to me as though you were explaining the study with epigentics as the reason.

[pnwmom]

15. Thanks for taking the time to read my first post. I wasn't really addressing the OP's study.

I was just disagreeing with the idea that was expressed in # 6 that autism simply is "a genetic difference."

[kcr]

16. But it is a genetic difference

I don't recall anyone saying it was simple, however.

[pnwmom]

17. That is how I interpreted the post. Opinions will differ. n/t

[kcr]

18. So I didn't put words in your mouth, after all.

Glad we cleared this up.

[pnwmom]

19. You did. I was addressing the previous poster, who first dismissed out of hand

the possibility that SSRI's could be implicated in autism and then said it was genetics that caused autism.

I don't know whether the SSRI study will turn out to be correct or not -- but I know that a combination of genetic and environmental factors is what most researchers say causes autism.

Also, there isn't a simple genetic difference that causes autism. There are different combinations of genes that are involved, and different environmental factors,, depending on the person.

[gitchel]

20. Simply?

Yes. It's a combination of genetics and environment. It's a genetic difference in how a person processes and responds to their environment. It might even be a genetically determined difference in how a person responds to things like SSRIs, power lines, traffic noise, parenting, whatever.

An autistic who never encounters things that he finds difficult to process, or who works very hard at coping with them, may even manage not to be diagnosed as autistic.

My dismissal was for a study that is trying very hard to imply that SSRIs are a major player in the cause of autism. Oh, and I was also dismissing a group of research institutions that are consistently delivering studies that almost universally have faulty premises, or methodology, or analysis, or tiny samples, or whatever it takes to produce the results desired by their sponsor. Especially when that sponsor is an organization that has huge pockets and a persistent interest in maintaining the fantasy that more and more donations can someday lead to a magic spell that can make your autistic kid into a "normal" kid.

I'm not interested in rehashing the huge amounts of back-and-forth that have already been dedicated to both these studies, since it always comes down to basic disagreements about what autism actually IS and someone shouting at someone else that they must hate autistic children - either because they don't want to cure them or because they do want to cure them.

I've already pointed out my doubts about the methodology of the SSRI study. As for the twin study you reference - one of dozens that never seem to prove anything final - it also seems to have been funded by Autism Speaks. And it is, once again, a justification for their need for more money to search for the pesky environmental causes for autism (which could certainly be vaccines or something dontchaknow). At the very least, most of the twin studies are flawed in the way they understand what autism is.

Autism is a genetic difference. But, since it is a genetic difference in how one interacts with one's envionment, (remember that each autistic is different in how they manage that extremely multidimensional interaction, and that these studies are very arbitrary in choosing what set of interactions and what level of success at those interactions should be consider "autistic" for each study), it is easy to conclude that the environment has a direct role in creating the autism. When you add in the many ways people arrive at a diagnosis, and the individual parental and family factors in reporting, and wide variances in medical access and education, and the WIDE range of coping abilities each autistic is continually trying to perfect, it's really more art than science to determine what you are actually looking at. Especially if you start out with biases, or build on "accepted practices" that may be just as flawed.

So, since I assume these scientists are educated and competent, I have to believe they are aware of how little "proof" there is at the end of these studies. And reading their papers, they usually do seem to pull up short of claiming such proof. Of course, the sponsors of these studies are welcome to make of them what they will. But I'm inclined to look suspiciously at an educated, competent group of scientists that keeps producing these chunks of confusion just because there's someone willing to buy them.

[pnwmom]

22. Very tiny samples ? Those scientists examined data from 145,000 pregnancies. 145 THOUSAND.

Hardly a tiny sample. And the University of Montreal is a respected research center.

[gitchel]

23. Tiny.

If you're replying to me...

The twin study referenced above used 202 pairs.

As for the University of Montreal, you go ahead and respect them, though I do wonder what they've done that earned that respect. Do you know them personally? Or is it some belief that an advanced degree and a white coat make one more trustworthy?

I suppose it could be the peer-review process. Though that process goes a lot easier if you write studies and articles that your peers are likely to approve

Look, you may be right about them. They may be perfectly respectable. But that doesn't mean their science is beyond investigation, or should be taken at face value. Not only is there large sums of cash involved in these studies, there are also many ways to do science. Otherwise, we could just get by with one study done by one scientist. Instead we have many studies done by many schools with many different conclusions. There are equally respectable scientists who've concluded significantly different results.

On the other hand, I don't respect sloppy science made to order.

[pnwmom]

24. If I were pregnant and had depression that wasn't severe, I'd take a chance

on this study and not take an SSRI.

As it is, the FDA says there is no proven benefit for SSRI's except for severe depression -- not mild or moderate -- although many doctors prescribe it anyway. So it surely wouldn't be worth taking a chance during pregnancy.

[Orrex]

28. Presumably both would be affected by antidepressants taken during pregnancy, no?

Last edited Tue Dec 15, 2015, 02:26 PM - Edit history (2)

They have 100% identical genetic factors and 100% identical environmental factors for the first nine months, at least.

It would be interesting to learn how one might be affected by the mother's drug intake and not the other.


Not dismissing the study, by the way; 87% is hard to dismiss outright, though the results might be hard to tease out because of the massively widespread use of antidepressants and, possibly, other factors that lead the mother to take them.

It's also unfortunate that, if true, this might lead to horrible feelings of guilt even though the mothers didn't knowingly do anything wrong in taking the medications prescribed to them.

[Blue_Adept]

21. Whoa whoa whoa

I saw this segment on GMA this morning and am now totally confused.

As was explained by the family doctor on the show, it was a study done where the difference between those on antidepressants and those not had a very small difference overall:

not on antidepressents was 1% whose children had autism
those on antidepressants was 1.5% whose children had autism

[pnwmom]

25. That isn't a small DIFFERENCE. The difference between those numbers is 50%.

In other words, those on anti-depressants, according to those numbers, would have a 50% greater risk.

[groundloop]

26. But that's a 50% increase