From the Guidelines
There is no conclusive evidence that selective serotonin reuptake inhibitors (SSRIs) cause autism, as suggested by a meta-analysis that found no increased risk of ASD associated with SSRI exposure during pregnancy compared to non-SSRI antidepressants 1. When considering the potential risks and benefits of SSRI use during pregnancy, it is essential to weigh the potential impact on the mother's mental health and the fetus.
- The observed association between maternal SSRI use and ASD may be due to confounding by indication, such as the underlying maternal depression or anxiety, rather than the medication itself 1.
- A study that used maternal antipsychotic treatment during pregnancy as an active comparator found that prenatal exposure to antidepressants was not statistically significantly associated with an increased risk of ADHD, suggesting that factors related to maternal use of psychotropic medications during pregnancy may confound associations between prenatal antidepressant exposure and neurodevelopmental problems 1.
- Depression during pregnancy poses its own risks to both mother and child, and untreated maternal mental health conditions can have negative impacts on child development.
- Women taking SSRIs who are pregnant or planning pregnancy should discuss their specific situation with their healthcare provider rather than discontinuing medication without medical supervision, as the causes of autism are complex and likely involve multiple genetic and environmental factors interacting in ways that are not yet fully understood 1.
From the Research
SSRI Use and Autism
- There is no direct evidence to suggest that SSRI use causes autism 2, 3, 4, 5.
- Studies have investigated the effects of SSRI use during pregnancy on newborn neurobehavior, finding disruptions in neurobehavioral outcomes, but no clear link to autism 3.
- Research has focused on the potential risks and benefits of SSRI use during pregnancy, with some studies suggesting that SSRIs may be associated with increased risk of complications, but the evidence is not conclusive 2, 3.
- Other studies have explored the use of SSRIs in adults with autism spectrum disorder, finding that cognitive behavioral therapy and mindfulness-based stress reduction may be effective in reducing anxiety and depression in this population, but do not address the question of whether SSRIs cause autism 6.
Key Findings
- SSRI-exposed infants have been found to have shorter mean gestational age, be more motorically active and tremulous, and show fewer rhythms in heart rate variability compared to non-exposed infants 3.
- There is a lack of understanding of the complexities and interactions between SSRIs in the developing brain of a young person with depression, and adults without certain risk factors do not seem to carry an increased risk of suicidality associated with SSRI use 5.
- Mindfulness and cognitive behavioral therapies may be promising treatment methods for reducing comorbid anxiety and depression in adults with autism spectrum disorder, but do not provide evidence on the relationship between SSRI use and autism 6.