So this tweet goes out on Twitter today saying that Zoloft causes autism when women take the medication during pregnancy. Mamas start getting nervous. Upset. Understandably so.
As you might imagine, I take immediate notice. What is the source? I find the tweet that started it all. It says there’s a link between autism and Zoloft.
The tweet is from Autism Now. Wow. That’s a major organization in Washington DC. It’s the National Resource Center for Autism. Except, wait a minute, Autism Now’s twitter handle is @AutismNowCenter, not @AutismNow. It’s not the credible, nationally-recognized organization that is sending out the tweet. Instead, this account seems to be registered to someone named “Change Agent.” I’m guessing that’s not the person’s real name. Anyway, the account appears to be a straight feed of autism-related news.
Let’s check the link in the tweet that caused the commotion on Twitter this morning. It goes to a site called autism-blog.com, which is apparently a site where anyone can blog about autism. To join and write on this site, all you have to do is enter your email address. The person who wrote this particular story is sandra_8907. Sandra has only posted at the site twice, and both of her posts say the same thing.
She refers to a study done in the Archives of General Psychiatry and then links to one particular lawyer’s website. She writes:
“The Archives of General Psychiatry also reported that children whose mothers took antidepressants during pregnancy ‘are twice as likely as other children to have a diagnosis of autism or a related disorder.'”
This is the sentence that has caused the concern. I checked the news reports on the research linking autism to taking antidepressant medication during pregnancy. There are a few things she doesn’t mention in her short post.
CNN reported, among other things:
“The lead author of the study, Lisa Croen, Ph.D., the director of autism research at Kaiser Permanente Northern California, a large nonprofit health plan based in Oakland, emphasizes the preliminary nature of her team’s findings. ‘This is the first study of its kind to look at the association, and the findings have to be interpreted with a lot of caution,’ she says. ‘We can’t detect causality from one study.'”
WebMD reported, in part:
“The Kaiser Permanente researchers conclude that even if the association is confirmed, SSRI exposure is not likely to be a major risk factor for autism and related disorders.
Tracy Flanagan, MD, who is director of women’s health for Kaiser Permanente Northern California, says maternal depression itself may be an unrecognized risk factor for autism. In the study, the researchers found no link between a history of depression or other mental health disorder and ASD.”
Science Daily reports:
“‘Although the number of children exposed prenatally to selective serotonin reuptake inhibitors in this population was low, results suggest that exposure, especially during the first trimester, may modestly increase the risk of ASD,’ the authors conclude. ‘We recommend that our findings be considered as preliminary and treated with caution, pending results from further studies designed to address the very complex question of whether prenatal exposure to SSRIs may be etiologically linked to later diagnoses of ASDs in offspring.'”
When the study first came out, I checked with the perinatal mood and anxiety disorder experts I know about this and wrote about it the possible link between autism and antidepressants here. As I wrote then:
“They don’t know whether it was the treatment (SSRIs), or the illness for which the mom is being treated (antenatal depression/anxiety, or depression/anxiety she has always had), or some genetic factor in the mom that may be related to both autism and the fact that she is vulnerable to depression/anxiety that led to the incidences of autism in the study. Not to mention the women whose children have an autism spectrum disorder who have none of the above.”
The Massachusetts General Hospital’s Center for Women’s Mental Health also commented on the study at its own website:
“Because children with ASD are more likely to have a family history of psychiatric illness, this study attempted to distinguish between the effects of medication exposure versus the effects of the underlying disease that led to treatment. While previous history of mood and anxiety disorders is factored into the analyses, acute illness during pregnancy is not factored in. Multiple studies suggest that untreated depression may lead to physiologic changes which negatively affect fetal development and birth outcomes; thus, this omission greatly diminishes the value of the article to assess the impact of SSRIs in pregnancy on the risk of autism in children.”
Does this mean antidepressants are safe during pregnancy? No. There is no medication that is 100% safe during pregnancy, as we’ve always said. Research shows, however, that depression and anxiety during pregnancy are not believed to be 100% either. Which is why it is so important to talk to your doctor.
There are a variety of potential options for the treatment of mental illness during pregnancy, including therapy, things like acupuncture, and also medication if that is indicated in your situation. You might consider reviewing the guidelines from the American Congress of Obstetricians & Gynecologists and the American Psychiatric Association.
In the meantime, please know that it is important to check several sources on a story, and also to talk to your doctor, before coming to any conclusions and worrying yourself needlessly.