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Antidepressants During Pregnancy: Benefits for Children

Children whose mothers were treated with antidepressants during pregnancy showed no differences in IQ, language, or temperament development from children with nondepressed, untreated mothers.

Because depression is highly prevalent during pregnancy, it is paramount to determine whether antidepressants taken by the mother are safe for the child's development. Investigators have reported that antidepressants taken during the first trimester of pregnancy showed no effect on children's cognition. The same research group now reports on developmental outcomes of children whose mothers took antidepressants throughout all 3 trimesters to treat psychiatrist-diagnosed major depressive disorder. The investigators followed 46 mothers on a tricyclic antidepressant, 40 mothers on fluoxetine, and 36 nondepressed, unmedicated mothers (controls). Developmental testing of the children was conducted between 15 and 71 months of age.

No differences in children's IQ, language, or temperament development were found among the 3 groups. There were significant associations between the duration of depression and children's low IQ and between the number of depressive episodes and children's impaired language development. Breast-fed and formula-fed children did not differ on measures of IQ or language.

Comment: These findings highlight the need to balance the potentially deleterious effects of maternal depression against the speculated harmful effects of antidepressant medications on children's development. As the authors note, effects may yet appear later in development; studies to address the extended effects during childhood are warranted. The poorer language development in children of depressed mothers is consistent with data showing better language ability with more mother-child verbal interaction. It is important to emphasize the absence of harmful effects of maternal antidepressant treatment in breast-fed offspring because of the multitude of benefits to children from breast-feeding.

— Barbara Geller, MD

Published in Journal Watch Psychiatry December 19, 2002

Citation(s):

Nulman I et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: A prospective, controlled study. Am J Psychiatry 2002 Nov; 159:1889-95.

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