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 The results indicate that at least part of the link previously seen
between kids’ exposure to antidepressants during pregnancy and their
risk of developing ADHD may be explained by “family factors” such as
maternal depression, rather than the drugs themselves, the study
authors write in The BMJ.
When the researchers compared the children of women with psychiatric
disorders who had either taken antidepressants during pregnancy or
only before pregnancy, they found the ADHD risk among their children
was similar. This was also true for siblings with the same mother
but different exposures to antidepressants during pregnancy.
“Pregnant women should not stop treatment because of concerns of
ADHD in their children in the future,” senior study author Ian C.K.
Wong, of the school of pharmacy at University College London said by
email.
In the study of 190,618 kids born in Hong Kong from 2001 to 2009,
just 3 percent of the children were diagnosed with ADHD or treated
for the condition after an average follow-up of more than nine
years.
The type of antidepressant might matter. Researchers didn’t find a
meaningful association between children’s ADHD and their mother’s
use during pregnancy of a family of drugs known as selective
serotonin reuptake inhibitors (SSRIs) that includes Prozac, Zoloft
and Celexa, according to the report in The BMJ.
Women who took other types of antidepressants while pregnant were 59
percent more likely to have kids with ADHD than women who didn’t use
any antidepressants, however. This might be because women with
milder depression typically get SSRIs first, and only try other
drugs when they have more severe psychiatric problems that aren’t
helped by SSRIs, the authors note.
Even when women never used antidepressants, mothers with psychiatric
disorders were 84 percent more likely to have kids with ADHD than
mothers without mental health problems, the study also found.
One limitation of the study is that it only included births at
public hospitals, the authors note, but this is where most
specialist care for kids with brain development issues is provided
in Hong Kong. Researchers also used prescription records to assess
whether women took antidepressants, which don’t always reflect the
drugs people actually take.
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Four of the study authors report past grants or consulting work for
companies that make antidepressants, and one is an employee of
Janssen Research and Development, LLC, a Johnson and Johnson
division with an antidepressant under development.
Left untreated, depression during pregnancy is associated with
underweight babies who are more likely to wind up in neonatal
intensive care, previous research has found. Pregnant women with
uncontrolled depression may not eat well or keep up with prenatal
visits, and, in the most severe cases they may be at increased risk
for suicide.
Like many drugs, antidepressants fall into a gray area during
pregnancy, with insufficient evidence to definitively prove the
harms or benefits. Often, doctors may only consider these drugs for
women with more severe depression.
Because some uncertainties about antidepressant use in pregnancy
remain, it still makes sense to reserve them for women with serious
psychiatric symptoms, Wong said.
“Pregnant women with mild depression may benefit from non-drug
treatment such as psychotherapy,” Wong added.
The study findings aren’t surprising, however, and should reassure
women who do need to take antidepressants during pregnancy, said Dr.
Roy Perlis, a psychiatry researcher at Harvard Medical School in
Boston who wasn’t involved in the study.
“No one wants to take medications they don’t need,” Perlis added.
“But people sometimes forget that depression itself carries risk.”
SOURCE: http://bit.ly/2qIxcNR The BMJ, online May 31, 2017.
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