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How antidepressants may subtly alter a growing baby’s brain
By Susan Gaidos June 5th, 2010; Vol.177 #12 (p. 22)

A pregnant question

Drugs known as SSRIs can fight depression during pregnancy but may
also have a lasting effect on a developing baby's brain. Comstock/
PhotolibraryThe glow of pregnancy is no shield against depression.
Millions of expectant mothers rely on antidepressant medication for
help. But treating mom with drugs at this time in her life may have
long-term consequences for baby.

Around 10 percent of women suffer bouts of despair during the hormonal
chaos of pregnancy or in the months after delivery. Some women are
already being treated with antidepressants such as Prozac and Zoloft,
while others get new prescriptions. For many adults these drugs, known
collectively as selective serotonin reuptake inhibitors or SSRIs, work
as advertised: lifting mood by temporarily boosting the availability
of the brain chemical serotonin. But SSRIs may have a different, more
long-lasting effect on a developing baby’s brain.

Over the past few years, a handful of studies have found that mice and
rats exposed to antidepressants shortly before birth or just afterward
grow up anxious and depressed. Other animal studies link early
exposure to SSRIs to improved decision-making and spatial-learning
abilities. Though many of the documented reactions fall within the
normal range of behavior, the drugs can influence how an animal
experiences and relates to its surroundings, says Judith Homberg of
Radboud University in Nijmegen, the Netherlands.

No one knows for sure if people experience the same risks or benefits
over the long haul, but a new study shows that children exposed to
antidepressants in the womb are more likely to appear sad or withdrawn
at age 3 than those whose moms didn’t take the drugs.

Though the mechanism underlying such changes is still unknown, a
picture is beginning to emerge. In the February Trends in
Pharmacological Sciences, Homberg and her colleagues outline research
in animals linking exposure to SSRIs during early development to
faulty brain organization and abnormalities. And recent studies in
fruit flies support a theory that sensitivity to serotonin can be set
early in life.

“You don’t necessarily get ill because of a change in brain
development by serotonin, but it may change your personality traits,”
Homberg says. “We may be changing the brain in subtle ways that we
still don’t understand.”

Despite these recent findings, doctors caution women against stopping
treatment, because the risks of depression — for mom and baby — may
outweigh those of the medication. Recent studies grapple with how to
separate the effects of SSRI exposure from the damage wrought by
depression in mothers.

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