Prenatal antidepressant use and risk of autismBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3388 (Published 19 July 2017) Cite this as: BMJ 2017;358:j3388
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The consequences of taking antidepressants in pregnancy to treat depression is seen as a question of risk versus benefit. Over 37 years ago I wanted something to alleviate the distress I felt as a result of my failing marriage. When I was prescribed clomipramine, a tricyclic antidepressant for the last seven weeks of pregnancy, I did so after assurances from my psychiatrist that it was safe. I had no reason to doubt him. In the event my son was admitted to the special care baby unit at 8 hours after birth due to having a generalised seizure attributed to clomipramine withdrawal. Convulsions persisted until he was 53 hours of age. He was finally discharged from the special care baby unit after 16 days. At that time no sustained ill effects were apparent. I appreciate my psychiatrist had only acted in my best interests and had no prior indication that clomipramine was inadvisable in the last trimester of pregnancy.
In the proceeding years my son has struggled with serious deficiencies in memory and concentration. It adversely affected his schooling. He was seen on a number of occasions in his early years by educational psychologists who noted his problems but had no real answers to give us for the difficulties he suffered. Only in his twenties were we given a diagnosis of Asperger's Syndrome which with the benefit of hindsight seemed pretty evident. Now in his 30s my son has had to face up to a decision I made on his behalf before he was born. In terms of risk versus benefit I have to ask as a parent, was the risk worth it given so many now question the efficacy of antidepressants in general? And can doctors be entirely certain of giving their patients assurances of safety for antidepressant prescribing in pregnancy? The next generation deserve an honest answer.
Competing interests: No competing interests