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Antidepressants have recently come under scrutiny by top U.S. health officials despite their well-established safety and efficacy profiles.<\/p>\n<\/div>\n
A large international study investigated whether antidepressant use before or during pregnancy is linked to neurodevelopmental disorders in children. <\/p>\n<\/div>\n
The comprehensive review, published online in According to the American College of Obstetricians and Gynecologists (ACOG), around 10%<\/a> of pregnant people experience depression. Untreated mental illness can lead to risks for both the pregnant person and their baby.<\/p>\n<\/div>\n Antidepressants, therefore, are commonly prescribed during and after pregnancy.<\/p>\n<\/div>\n Despite this, Secretary of Health and Human Services Robert F. Kennedy Jr. discourages<\/a> the use of selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed class of antidepressants. <\/p>\n<\/div>\n These new findings could help dispel misinformation around antidepressant use during pregnancy.<\/p>\n<\/div>\n<\/div>\n The researchers reviewed dozens of previous studies to better understand whether antidepressant use before or during pregnancy was linked to neurodevelopmental conditions in children. <\/p>\n<\/div>\n They examined outcomes including ADHD, autism spectrum disorder, intellectual disabilities<\/a>, motor disorders, and speech or language delays.<\/p>\n<\/div>\n To do this, they searched several major medical research databases and screened nearly 2,000 studies before selecting 37 high quality studies to include in their final analysis.<\/p>\n<\/div>\n Altogether, the research covered more than 648,000 pregnancies involving antidepressant exposure and nearly 25 million pregnancies without exposure.<\/p>\n<\/div>\n The researchers combined the findings from these studies and adjusted for factors that could affect the results, such as maternal mental illness, family genetics, and differences in how antidepressant exposure was measured. <\/p>\n<\/div>\n They also looked at different types of antidepressants<\/a>, when they were used during pregnancy, dosage levels, and even paternal antidepressant use to help determine whether other underlying factors could explain the findings.<\/p>\n<\/div>\n To improve transparency and research quality, the study plan was registered in advance through PROSPERO, an international database for systematic reviews.<\/p>\n<\/div>\n <\/div>\n The analysis found that when mothers used antidepressants during pregnancy, there was a small increase in the chance of their children developing certain neurodevelopmental disorders, such as ADHD and autism.<\/p>\n<\/div>\n This increased risk was seen whether the antidepressants were used before or during pregnancy.<\/p>\n<\/div>\n However, the researchers also found that when they carefully considered other factors \u2014 like the pregnant person\u2019s mental health history or comparisons between siblings \u2014 the link between antidepressant use and these disorders became much weaker or disappeared entirely. <\/p>\n<\/div>\n The researchers suggest that the underlying mental health of the parents and other family factors might explain most of the risk, rather than the antidepressant use itself.<\/p>\n<\/div>\n Further bolstering the idea of the role of genetic or environmental factors, the team also found that the fathers\u2019 antidepressant use during their partner\u2019s pregnancy was linked to a greater chance of ADHD or ASD in children.<\/p>\n<\/div>\n The study, however, did not find increased risks for other developmental issues<\/a>, such as intellectual disabilities or speech and language problems. Also, taking higher doses of antidepressants did not appear to increase the risk.<\/p>\n<\/div>\n Among the different types of antidepressants, only two older medications, amitriptyline<\/a> and nortriptyline<\/a>, were consistently linked with higher risks. However, these drugs are less commonly prescribed and often reserved for severe depression. <\/p>\n<\/div>\n More commonly prescribed antidepressants, like the SSRIs fluoxetine and sertraline<\/a>, did not show a clear increased risk once the pregnant person\u2019s mental health was taken into account.<\/p>\n<\/div>\n Overall, the evidence was not strong and was limited by differences in study methods and remaining uncertainties. <\/p>\n<\/div>\n The authors also emphasize that untreated depression during pregnancy<\/a> carries its own risks for both the pregnant person and the baby, highlighting the need for careful, personalized decisions about antidepressant use during pregnancy.<\/p>\n<\/div>\n<\/div>\n Sandra Dunkin, MD, a board certified psychiatrist and founder of BrainWell Psychiatry<\/a>, said the review\u2019s findings reinforce what she has seen in her own practice. Dunkin wasn\u2019t involved in the research.<\/p>\n<\/div>\n \u201cThis research is genuinely reassuring, and I want women to hear it clearly: the evidence does not support a causal link between antidepressant use in pregnancy and neurodevelopmental conditions like autism or ADHD,\u201d she told Healthline.<\/p>\n<\/div>\n Dunkin said this is important because the fear of causing harm to their baby has led many women to discontinue necessary medications, which can have serious consequences.<\/p>\n<\/div>\n Abrupt cessation of an antidepressant without going through a period of tapering off under your doctor\u2019s supervision can lead to antidepressant discontinuation syndrome<\/a>, which may lead to a range of unpleasant symptoms, including: <\/p>\n<\/div>\n Additionally, females may experience a return of their depression symptoms, including suicidal ideation<\/a>.<\/p>\n<\/div>\n There are also effects on the developing fetus to consider, said MaryEllen Eller<\/a>, MD, a board certified psychiatrist with Radial Health who wasn\u2019t involved in the review.<\/p>\n<\/div>\n Managing mental health conditions<\/a> such as depression and anxiety during pregnancy \u201cis not a choice between treatment risk and no risk,\u201d she told Healthline. Instead, it\u2019s a matter of choosing between competing risks, Eller said.<\/p>\n<\/div>\n \u201cA growing body of research shows that untreated mental illness during pregnancy carries real consequences for both mother and baby, including premature birth<\/a>, low birth weight<\/a>, high blood pressure<\/a> complications, and long-term effects on a child\u2019s brain development such as increased risk of anxiety, ADHD, learning difficulties, and mood disorders<\/a> later in life,\u201d Eller said.<\/p>\n<\/div>\n Additionally, while antidepressants are not completely without side effects, the likelihood of serious complications is low, she noted.<\/p>\n<\/div>\n Also, not all antidepressants have the same risk profile, so switching to another medication is also an option.<\/p>\n<\/div>\n \u201cWhen medications are prescribed, providers aim for the lowest dose that fully controls symptoms \u2014 because under-treating mental illness carries its own risks,\u201d Eller said. <\/p>\n<\/div>\n\n