The headlines were based on a new Johns Hopkins study published in the journal Pediatrics that doesn’t actually show that antidepressants cause autism. That’s because it was designed in a way that can’t establish cause-and-effect. And evidence on this issue conflicts: Two larger studies published in November and December 2013 found no evidence of a link between use of these drugs during pregnancy and autism after accounting for important factors. In the new study, researchers interviewed 966 mothers of 2- to 5-year-olds about the drugs they took immediately before pregnancy, during pregnancy, and while breast-feeding. A little more than half the moms had children with autism; the rest either had healthy kids or children with other developmental disorders. The researchers found that, overall, the mothers of kids who had autism were no more likely to have reported taking SSRI antidepressants (like Prozac, Zoloft, and many others) during pregnancy than the other moms did. But when they looked at only the women with autistic boys, they found that they were more likely to have reported taking SSRIs during pregnancy compared with other boys’ moms. So, there’s a link there, but we can’t necessarily point fingers at the drugs. For one thing, most women take antidepressants because they suffer from depression, so one major confusing factor here is whether the antidepressants themselves increase autism risk or whether it might be the underlying depression instead. “This is not an easy issue to answer,” says Dheeraj Rai, a psychiatrist who studies antidepressants and autism at the University of Bristol in the UK. When the November and December studies took this possibility into account, controlling for the potential effects of underlying depression, any association between antidepressant use and autism risk disappeared. A 2008 study, also published in Pediatrics, found that people with autism are 70% more likely than other people to have parents with psychiatric disorders such as depression, which suggests that genetics may play an important causal role. The new study also relied on information gleaned through phone interviews—the researchers asked the mothers what medications they had taken when they were pregnant years before—and some may not have remembered correctly. (The earlier studies, meanwhile, relied on medical records.) “There are many factors to consider; we didn’t intend for our study to be used as a basis for clinical treatment decisions,” the study’s co-author, Li-Ching Lee, told WebMD. The question of whether it’s safe to take antidepressants during pregnancy is the subject of ongoing debate. “There may be side effects that are unknown,” says Merete Sørensen, a psychiatrist at the Regional Centre of Child and Adolescent Psychiatry at Aarhus University Hospital in Denmark and a co-author of the November study. But importantly, she says, “untreated depression in the mother may also have harmful effects,” so taking antidepressants may sometimes be safer than not taking them. If you’re concerned—and confused—about what to do, Rai recommends discussing the pros and cons with a doctor in order to make the most informed decision possible. More from Prevention: The 100 Cleanest Foods You Can Buy
