An Autism Prevention

Since there are multiple proposed factors that could lead to autism, some of them, at least, ought to be preventable. Proven associations due to environmental pollution or toxic foodstuffs are under little personal control, however.

Research that recently appeared in a respected medical journal could provide a key causative factor in the rising number of cases of ASD, plus a valuable tool that women can use to decrease their risk of having an affected child.

Pro Antidepressants
The party line has been that, while perhaps not totally safe, there are increased risks of developmental and other abnormalities from stress and/or anxiety, alone. Twenty years ago, an important study ‘established safety’ when it was reported that, “Women who take <<Prozac>> during pregnancy do not have an increased risk of spontaneous pregnancy loss or major fetal anomalies…” BTW, autism was hardly on the radar when that dogma was announced in 1996.

As recently as 2013, an article in the BMJ concluded, “However… antidepressant use during pregnancy is unlikely to have contributed significantly towards the dramatic increase in observed prevalence of autism spectrum disorders as it explained less than 1% of cases.” This was in the face of their data that showed, “In utero exposure to both SSRIs… was associated with an increased risk of autism spectrum disorders…”

Anti Antidepressants
There are various types of antidepressants, depending on the neuro-chemical response in the brain (and other parts of the body that have similar cells). The most popular have become the SSRIs, and their use has taken off since the first decade of this century.

These medications are not approved by the FDA for children < 7 years of age.

SSRIs are “not for use in nursing.”

The Physician’s Desk Reference also documents, “Absorption… in about 6-8 hours… Crosses the placenta…Found in breast milk…Elimination… in about 4-16 days.”

Assuming the earliest that pregnancy can be discovered is about two weeks, even if medication were discontinued immediately, the fetus would be exposed throughout the entire first month of gestation.

The main organs that form in those early months are the circulatory and nervous systems.

Coincident with the dramatic rise in the use of antidepressant medication is an epidemic of signs and symptoms that are now referred to as Autism Spectrum Disorder.

Discussion
The most recent article, Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children, concluded, “Use of antidepressants, specifically selective serotonin reuptake inhibitors, during the second and/or third trimester increases the risk of ASD in children, even after considering maternal depression.” There was an 87% increased risk.

While discussing the topic, a friend said to me, “I am not a doctor or anything, but it seems to me that if a woman cannot have a glass of wine once in a while, how could a daily drug for the brain be OK?”

Caution is not warranted. Women who wish to get pregnant should discontinue this pharmaceutical treatment for their depression and seek other ways to get relief from stress and anxiety.

Conclusions
Parents are not to blame for this predicament. Pharmaceutical companies are not interested in performing further testing, and doctors have been too trusting in the face of self-serving science, financial incentives, and common sense.

These medications should be highly avoided unless further study proves absolute safety, which seems unlikely.

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Brian D. Udell MD
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