A recent study has raised some questions about that safety of certain antidepressants. The study, which was published on Monday in JAMA Pediatrics, says that taking SSRIs during the second and third trimesters of pregnancy may increase the risk of a child being born with autism spectrum disorder (ASD). A claim like this could lead to some serious litigation against antidepressant manufacturers, but before we get ahead of ourselves, let’s take a look at the study itself.
The new study examined more than 145,000 children born in Quebec between 1998 and 2009 and found that children whose mothers took SSRIs during the second or third trimester of pregnancy were 87% more likely to be diagnosed with ASD. The study accounted for mothers who stopped taking antidepressants during the first trimester by comparing them with mothers who continued taking the medications. They also, reportedly, identified mothers with a history of psychiatric disorders when compiling data. Anick Berard, the study’s senior author, says that these considerations solidify their claims that the 87% increase was inevitably caused by antidepressants. But, other scientists in the field aren’t so sure.
One concern is that the results from this single study will be over interpreted. Professionals are skeptical because the results in studies prior to this one have been pretty ambiguous. Earlier this year, a study of several thousand U.S. children found no relation between antidepressants and an increased risk of ASD. A study of roughly 670,000 Danish children found similar results. Two smaller studies, one in Sweden in 2013 and one in California in 2011, found the opposite to be true, stating that antidepressants may moderately increase the risk of ASD.
These cases are so confusing because there’s already strong evidence that mothers who suffer from depression are already more likely to have children with ASD, regardless of whether they take antidepressants during the pregnancy. This makes it difficult to separate the effects of depression itself from those caused by the medication being used to treat it.
Bryan King, the program director of the autism center at Seattle Children’s Hospital, pointed out that depression can result in poor nutrition, sleep problems and stress, all of which can affect the health of a developing fetus. King also claims that the 87% increase found in the study is based on only 31 children who developed ASD after being exposed to SSRIs and that many of them would have developed autism anyway.
This also makes it a challenge for any litigation to stick. Granted, a number of SSRI makers (including Pfizer, the manufacturer of Zoloft) have already been sued by mothers who took the drugs during pregnancy. The difference in those cases? The birth defects cited by those lawsuits were strictly physical, and even though the multidistrict litigation against Zoloft is still ongoing and includes hundreds of cases, none of them mention ASD.
The cases linking Zoloft and other SSRIs to birth defects – heart and brain issues mostly – present a stronger argument than those that would potentially allege a correlation between SSRIs and ASD. This is simply due to the fact that the lifeblood of a lawsuit lies in causation, that product X directly led to injury Y. Without proof of that, you typically don’t have a case. So, could individuals prove that taking an SSRI during pregnancy caused a child’s autism – directly and without room for any real argument? That might be pretty difficult considering that no one really knows what causes it.
There are attorneys looking into cases on behalf of SSRI users whose children were born with autism, but there aren’t currently any lawsuits moving forward. One thing is for sure though – one study isn’t enough to take the proverbial torches and pitchforks to antidepressant companies, at least, not just yet.