A new study from Denmark may put to rest the concerns pregnant women suffering from depression have about taking antidepressants and their possible link to asthma in babies. The research suggests that newer antidepressants known as selective serotonin reuptake inhibitors (SSRIs), are not associated with an increased risk of childhood asthma.
“The safety of antidepressant use during pregnancy has never been evaluated in randomized controlled trials,” lead author Xiaogin Liu, MD, an epidemiologist at the department of public health at Aarhus University in Denmark, told MedPageToday. “We hope our study will contribute knowledge to the safety of antidepressants use during pregnancy.”
For the study, Liu and her colleagues analyzed the medical records of more than 733,000 Danish children born between 1996 and 2007. The team identified mothers who had been diagnosed with depressive disorder and/or who used antidepressants one year before or during pregnancy.
Of the study group, 21,371 children were born to mothers who were depressed or who had taken antidepressants during pregnancy. Study findings showed that babies born to depressed mothers who did not take medications, were 25 percent more likely to develop childhood asthma than children born to mothers who were not depressed. Of the nearly 9,000 mothers who had been prescribed antidepressants, 80 percent were given SSRIs, and no link was found to an increased risk of asthma. Commonly used SSRIs include Zoloft, Prozac and Celexa.
Among the mothers who were taking the older drugs, known as tricyclic antidepressants, the increased risk for having a child with asthma was 26 percent. The study authors acknowledged that their research did not prove that the older antidepressants – including Norpramin, Tofranil and Pamelor – caused childhood asthma, only that there was an association. They also noted that these drugs were used to treat more severe depression, which past research has tied to asthma.
“Tricyclic antidepressants have different pharmacokinetic properties than SSRIs, but the association may be confounded by underlying severity of depression,” Liu told HealthDay. Liu also admitted that it is not clear how a mother’s depression might contribute a child’s asthma. Other factors, including biological changes that take place during pregnancy, or environmental or genetic influences, or all three could also be at play, said Liu.
Given that untreated depression may be a contributor to childhood asthma and other negative outcomes, including preterm birth and low birth weights, depressed mothers-to-be sometimes face a difficult decision.
“I think the controversy surrounding antidepressant use during pregnancy really has to do with the stigma of psychological illness,” Jennifer Payne, MD, associate professor of psychiatry and director of the Women’s Mood Disorders Program at Johns Hopkins School of Medicine in Baltimore.
“People forget about the risks of not treating,” added Payne. “Antidepressants are the best studied class of medications during pregnancy, as far as I know, and overall, the risks of taking them during pregnancy are quite small whereas the risks of untreated depression during pregnancy are quite large.”
Clearly, both options – treatment or not – deserve careful consideration. Healthcare experts advise such a decision should be weighed on a case-by-case basis under the guidance of a psychiatrist and with consideration of other methods of treatment.
