According to a major new study published in the journal The Lancet Psychiatry, there is no evidence of a causal link between the use of antidepressants during pregnancy and the risk of neurodevelopmental disorders in children, including autism and attention-deficit/hyperactivity disorder (ADHD).
The systematic review and meta-analysis, conducted by researchers at the University of Hong Kong, synthesized data from 37 different studies. These studies involved more than 600,000 pregnant women who took antidepressants and nearly 25 million who did not. This represents the most robust and accurate evidence to date, debunking the findings of smaller-scale studies conducted approximately a decade ago.
The initial, crude data suggested that antidepressant use during pregnancy was associated with a 35% increase in the risk of ADHD and a 69% increase in the risk of autism. However, once researchers accounted for confounding factors—including genetics and parental mental health status—this association virtually disappeared.
The study revealed that the risk of autism and ADHD also increased when fathers took antidepressants (46% for ADHD, 28% for autism), or when mothers used the medication before pregnancy rather than during it.
The research demonstrated that selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed class of antidepressants, are entirely safe. A correlation was only observed with the amitriptyline/nortriptyline group; however, scientists attribute this to the fact that these medications are typically prescribed for treatment-resistant and severe depression. Consequently, the risk in these cases is likely driven by the mother’s chronic and severe mental health condition.
The research team emphasizes that discontinuing antidepressants during pregnancy is associated with a high risk of relapse, which is often far more harmful to the fetus. Therefore, for patients with moderate to severe depression, doctors and patients must jointly weigh the benefits of continuing treatment against the potential risks of untreated depression.
Independent experts have also praised the study. They note that, amidst many contradictory findings, these results have a colossal impact on clinical practice—confirming that antidepressant use during pregnancy should continue, as they protect the mother’s mental health without compromising fetal development.
