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 Study leader Sven Sandin of the Icahn School of Medicine at Mount
Sinai in New York City told Reuters Health by email that while it
has generally been assumed that paternal use of antidepressants
holds no risk for a developing baby, this previously had not been
well-studied.
The results were not "a big surprise," he said, but are nevertheless
important, since there has been extensive research into the risks of
mothers taking antidepressants, but less attention paid to fathers.
"Depression and anxiety disorders are very common and many potential
fathers take antidepressant medication to treat these illnesses," he
wrote. "The findings from this study are reassuring for men using
antidepressant medication, showing that this does not increase risk
of autism, intellectual disability or birth defects for their
infants."
Sandin and colleagues studied 170,508 Swedish children who were
conceived between 2005 and 2007. The team tracked the children's
outcomes through December 31, 2014 using the Swedish Medical Birth
Register and the Swedish National Patient Register. They also used
the Swedish Prescribed Drug Register to identify fathers who filled
prescriptions of antidepressant drugs around the time of conception
and after a child was conceived, as well as fathers who did not take
any antidepressants.
After controlling for factors such as paternal and maternal age and
history of psychiatric disease, the researchers found that fathers'
use of antidepressant medications at conception did not increase the
risk to their offspring. They did find an increased risk of
intellectual disability in offspring of fathers who initiated
treatment after conception, but Sandin said this may be a chance
finding.
"Use after conception cannot affect the infant," he said.
Dr. Anna Sara Oberg of the department of Medical Epidemiology &
Biostatistics at the Karolinska Institutet in Sweden said she and
fellow researchers published a similar analysis of the same data
focused on maternal antidepressant usage in the Journal of the
American Medical Association last year.
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She said the new findings support previous research indicating that
underlying conditions and patient characteristics - rather than
antidepressant medication itself - may influence the risk of
neurodevelopmental disorders in children. Ideally, she said, the new
study would have tracked the outcomes of children past the age of 8
or 9, since some children may not receive a diagnosis by that age.
"As a result, these findings may target the more manifest and/or
severe cases," she wrote in an email to Reuters.
Dr. Sonia Hernandez-Díaz, a professor of epidemiology at the Harvard
T.H. Chan School of Public Health, said that there had been "no real
concern in the scientific community about paternal exposure." She
said that, for years, studies had implied a possible connection
between maternal use of antidepressants and the development of
neurodevelopmental or mood disorders in children. An increasing body
of evidence shows that it is likely not these medications, but,
rather, the mental disorders that led the mothers to take the
medications - or associated environmental or genetic factors - that
increases babies' risks for these problems.
"It is a sensitive issue and the possibility of an effect of taking
medications and hurting your child has created suffering and guilt
in women," she wrote in an email to Reuters.
"We have learnt from what we have done to moms, that we need to be
extra careful and thoughtful before screaming 'wolf,'" she added.
"In this sense, a negative study is important to publish and
communicate because had it been 'positive' (i.e., found an increased
risk) it would had been on the cover of the magazines."
SOURCE: http://bit.ly/2lnO109 BMJ, online June 8, 2018.
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