Antidepressants And Environment Linked To Autism


Two studies published this week (and getting lots of attention) look at possible causes of autism. One hints at a connection between autism spectrum disorders (ASDs)  and antidepressants, the other suggests that autism may have less to do with genes and more to do with environment than previously thought. The links are pretty vague in both cases. A resounding “more research needs to be done” accompanies all reports.

The antidepressant study–published in the Journal Archives of General Psychiatry and conducted by Kaiser Permanente–looked at records of more than 1,600 children and found that women who took SSRIs (such as Prozac, Zoloft, Paxil and Celexa) in the year before delivery had double the chance of having a child with an ASD than those women who did not. BUT. And this is a pretty big but,the results could be random as there were only 20 women in the study who took SSRIs and had a child with ASD.  Among the larger population, the studies authors write,”the fraction of cases of ASD that may be attributed to use of antidepressants by the mother during pregnancy is less than 3 percent…and it is reasonable to conclude that prenatal SSRI exposure is very unlikely to be a major risk factor for ASD.”

I think it’s good to land on that last line– this is a small number of people. And not statistically significant. And more research needs to be done… but I do applaud anyone studying possible causes of autism and safety of medication in pregnancy. Depression during pregnancy needs to be treated. It’s not uncommon and, as another study revealed earlier this month, doctors are often mystified as to how to help depressed prenatal patients.

The other study– also published in the Journal Archives of General Psychiatry this Monday– is coming under attack but it’s pretty interesting. Researchers looked at 192 set of twins, where one twin had ASD and came to the conclusion that environmental factors (in and out of the womb) may be more of a contributing factor to ASD than genetics alone. Previous research looking at twins has fallen heavily on the side of genetics. Many experts are baffled by the results of this new study. And the authors themselves concede that… more research needs to be done. I don’t know nearly enough about this but I wonder if it’s not a combination of environment in the womb and genetics– genes can be altered by the environment in the womb.

No hard answers here. The story of autism is always unfolding and seems resistant to easy explanations. It’s nice to see research and discussion extend beyond the vaccine question, however. I think that it’s always important to look at vaccines and question why we do them. But I also hope we don’t miss out on looking at how chemicals or other environmental factors may have an impact on fetal development. These two studies seem to be coming from researchers interested in pursuing that line of thought.