Magazine article Clinical Psychiatry News

Maternal Depression TX Not Tied to Neurodevelopmental Problems

Magazine article Clinical Psychiatry News

Maternal Depression TX Not Tied to Neurodevelopmental Problems

Article excerpt

A study that followed up children whose mothers took fluoxetine or tricyclics throughout pregnancy found no evidence that the drugs had an adverse impact on their neurodevelopment, said Dr. Gideon Koren, director of the Motherisk Program at the Hospital for Sick Children in Toronto.

But there was a significant association between maternal depression and adverse effects on some neurodevelopmental measures, such as IQ.

Dr. Koren and his associates at Motherisk recently presented the results of this prospective blinded study which compared 46 children whose mothers had taken tricyclics and 40 children whose mothers had taken the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac) throughout pregnancy with 36 unexposed controls. Children were followed until they were in preschool or of early school age.

The lead author of the study was Dr. Irena Nulman, associate director of the Motherisk program, which conducts research and provides information and counseling to women and health care providers on drug therapy during pregnancy.

They found no differences in IQ, language development, or temperament between the two groups of children, after adjusting for factors such as maternal IQ and socioeconomic class, smoking, alcohol use, and the duration and severity of the mother's depression.

There also were no differences in the same measures in the children whose mothers continued taking the medication while breast-feeding, Dr. Koren said, noting that relatively small amounts of SSRIs and tricyclics appear in breast milk.

What they did find, however, was a significant negative association between a child's IQ and the duration of maternal depression. There also was a negative association between language development and the number of episodes of depression a mother had after delivery.

"It is therefore clear that untreated depression during and after pregnancy can have an adverse effect on the neurodevelopment of children," said Dr. Koren, also professor of pediatrics, pharmacology, pharmacy, medicine, and medical genetics at the University of Toronto. He and his associates have presented these results at several meetings and have submitted the data for publication.

This is the first study to follow the neurodevelopment of children exposed to these drugs throughout pregnancy, according to Dr. Koren, who said that the issue was first addressed in an earlier Motherisk study Dr. …

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