SSRIs in Pregnancy Tied to Autism

[Jim__]

There is a link at the end of this article to the original paper in the Archives of General Psychiatry, but to read the full paper requires a login. The first 4 paragraphs from the article:

Prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) appears to be associated with increased chances of developing an autism spectrum disorder (ASD), although such an exposure is unlikely to explain many cases of autism, a case-control study showed.

Children born to mothers who received a prescription for any antidepressant in the year before delivery were twice as likely to have an ASD (6.7% versus 3.3%; OR 2.0, 95% CI 1.2 to 3.6), according to Lisa Croen, PhD, of Kaiser Permanente Northern California in Oakland, and colleagues.

But the relationship was significant only when an SSRI was one of the antidepressants taken, the researchers reported online in Archives of General Psychiatry.

Adjusting for maternal history of depression and other mental health disorders did not affect the finding.


more ...

[Demeter]

1. It's genetic, it's genetic, it's genetic

NO amount of spurious statistical correlation can prove otherwise...

Correlation is NOT causation.

[LeftishBrit]

2. It's mostly genetic but prenatal/perinatal factors are also involved

E.g. very premature babies are more likely to be autistic, and certain maternal infections also increase the risk.

It may be that people with conditions genetically related to autism are more likely to take SSRIs; but as SSRIs work on brain chemistry, it's not beyond possibility that they might affect a fetus' developing brain.

Further study of such factors is needed; it's a pity that so much attention was diverted to vaccinations.

[kestrel91316]

3. If it's genetic, why is the problem skyrocketing?

[laconicsax]

4. It isn't.

There have been studies that show that when you take the change in diagnostic criteria into effect, the increase in ASD cases evaporates.

There has been an increase in diagonses due to changed criteria, not an increase in instances.

[Odin2005]

6. It isn't, it's just being diagnosed more.

Before the mid 80s most autistic people were labeled as "mentally retarded" and shipped off to institutions. High-functioning Autism (Asperger's, etc.) was ignored until the early 90s. As late as 1990 it was common to find psychiatrists that said autistics had no mind or "inner mental life".

[Jim__]

5. The studies that I've read on autism acknowledge that there are probably multiple causes.

And, yes, everyone knows that correlation is not causation. The studies I've seen that claim the cause is genetic base that claim on statistical correlation; it's one natural starting point in epidemiological studies. Lisa Croen does not see this correlation as spurious - I suspect that her expertise in this area exceeds yours. And, environmental factors impact genetic factors, especially, in utero environmental factors.

[Demeter]

7. The studies that Show Genetic Causation are Families Demonstrating

Generational transmission, probably sex-linked, explaining why so many more boys than girls are affected, and multiple genes involved to account for the wide variation of symptoms amongst the affected.

[Jim__]

8. A recent study on autism that identifies genetics as a potential cause.

Their basis is correlation. An excerpt from an article on the recent study:

As the team notes in their paper, it is still very difficult to make the connection between the areas that the de novo CNVs hit and the genes these areas harbor. Nor is it clear what role those genes have in perturbing the biology of the developing brain, giving rise to autism. In the associated paper, Vitkup, Iossifov and others use a novel form of analysis called NETBAG (network-based analysis of genetic associations) to identify “the large biological network of genes affected by rare de novo CNVs in autism.” They note that this network is strongly related to genes previously implicated in studies of autism and intellectual disability. And they specify that the genes in question relate primarily to the development of synapses, the junctions between brain cells which are their transmission nodes; as well as the targeting of axonal fibers and the ability of young neurons to migrate. All are essential aspects of brain development.

Subsequent sequence-based studies should be able to further resolve individual genes within the CNV regions, and significantly expand the list of candidate genes for autism. Even now, however, the data on spontaneous CNVs and a separate but also an important class of “ultra-rare” CNVs that were inherited by some of the affected children in the sample, reveal interesting and in some cases vexing “asymmetries,” the team reported.

Among these asymmetries: spontaneous causal CNVs were found in 8% of the affected children in the sample; this is four times their rate of occurrence in unaffected siblings. Since CNVs occur with equal frequency across the human population – we all have them, but in most of us the missing or extra genetic material doesn’t hit essential genes or contribute to illness – the fact that they are seen four times as often in affected children as in their unaffected siblings points to their likely contributory role in the illness.

They don't know what role those genes have in perturbing the biology of the developing brain, giving rise to autism.

The author of the study also notes that the causes of autism are likely diverse:

“The causes of autism when fully fleshed out are likely to be very diverse,” Wigler says, “some of which may be treatable much more readily than others. However, the diversity of causes implies that an effective future treatment for one form of ASD may be specific only for a narrow subset of those affected.”

Note that in his description of diverse causes, he does not limit the causes to being genetic.

[Odin2005]

9. Autism clearly runs in my family.

My mom's dad was almost certainly an Aspie, and I have a severely autistic aunt. And even the folks who aren't on the spectrum are good at math.

Anyone who claims that autism isn't genetic is simply a liar.

[DLnyc]

10. Is saying that it's genetic three times causation?

"NO amount of spurious statistical correlation can prove otherwise"

Doesn't sound like a very objective approach to studying reality, with all due respect.

What is your evidence that it's genetic?