The latest edition of “health” magazine “What Doctors Don’t Tell You” claims that if a mother takes antidepressants during pregnancy, she triples the chances of her baby developing autism. Except that’s not quite what the study it references actually said….
Firstly – I have to thank the lovely writer of Nurture My Baby who posted about the WDDTY piece on twitter and brought my attention to it. She is also working on a blog post about it and I’ll update this post and link to it when she gets that up. She also makes lovely crochet things, I have no idea how to do that!
For those of you lucky enough not to know what WDDTY is, it’s a magazine, widely available in supermarkets etc. which claims to reveal the truths that doctors are hiding from us. That cancer can be cured with massive doses of vitamin C, that vaccinations give kids autism, and that all manor of “natural” remedies can cure pretty much everything. That sort of stuff. Of course they throw in lots of helpful adverts for these remedies to help us all out as well. So that’s nice of them.
This month they carry a small piece based on a study published in the BMJ. Here’s a few quotes from that piece:
“Women who take certain prescription drugs while pregnant are increasing the chances of Autism in their child”
“Antidepressants … have been associated with the learning and behavioural problem” *
“Women who suffer from depression during pregnancy should seek out non-drug therapies, say researchers from the university of Bristol”
The message from WDDTY is carefully worded but here’s how I reckon it would sound to a pregnant woman with depression, a women who already feels that she is utterly useless and inadequate:
If you take those pills from your doctor, you will damage your baby. You selfish cow.
This though, isn’t at all what the paper actually says. It doesn’t show a tripling of the chances of autism. It’s a bit less than double and it’s doubling a very small chance to make another very small chance. The researchers found no increase in the types of autism that include intellectual impairment (to my mind that doesn’t fit with the claims about learning problems). In fact you can’t actually tell from this study if it is the drugs that cause the few extra cases or autism or if it is the depression itself.
Depression is a horrible, horrible disease, but it comes and goes. We know from the study that autism is more likely in children whose mothers have been diagnosed with depression, but only if they were on antidepressants during pregnancy. What we don’t know is who was actually suffering symptoms of depression during pregnancy. Perhaps those who weren’t on medication were well at the time and those taking the drugs were suffering from current and severe depression? Perhaps this depression is what caused the autism and the use of medication merely indicates the severity of the mothers condition?
This isn’t me nit picking the data to suit my needs, the authors of the paper say the same thing, repeatedly:
Importantly, it is not possible to conclude whether the association between antidepressant use and autism spectrum disorder reflects severe depression during pregnancy or is a direct effect of the drug
There are a lot of things we just can’t tell from this study and the authors make this quite clear. They don’t call for an immediate end to antidepressant use in pregnancy, they call for more research, more information and a cautious approach in the mean time. That’s science. If the drugs are causing autism then they would still only account for 0.6% of cases and the rates of autism have rocketed in recent years. We still don’t know if this is due to increased awareness and willingness (perhaps over willingness) of doctors to diagnose the condition. It could well be that there is something causing a genuine increase, although it’s clear from this that if that thing exists it’s not just antidepressants in pregnancy.
Of course the small effect shown in this paper could be down to the drugs, so it’s not unreasonable to suggest caution when prescribing antidepressants in pregnancy. The paper’s authors suggest that psychological therapies may be a better alternative, but they also acknowledge that, sadly, it just wouldn’t be possible for most women to access these quickly enough. Over all, even if the drugs were definitely responsible, the risks of coming off medication may be far greater than of taking it. What doctors would tell you (hopefully) is that you need to weigh up these risks together, and for your own personal circumstances.
But of course this isn’t what WDDTY is all about. They don’t seem to see anything wrong in telling unwell, vulnerable women that if they are not actively out there, ignoring their doctor, hunting for alternatives themselves and throwing away the only thing that may be helping them, then they are permanently harming their precious unborn child. I mean, it’s not like these women are already feeling a bit bad or anything is it? Depressed people could probably do with a bit more guilt – right?
If this is the first time you’ve come across this magazine – this piece is only one small section of it. Most of the rest of the issue is devoted to cancer, and the little I could bear to look at isn’t any better. Just think on that for a moment.
PS. I’ve linked to the paper but not to WDDTY as I don’t want them to get the traffic, but if you see one in a shop have a look, then put it back, preferably in the wrong place and backwards.
* the piece also makes these claims about Epilim, an epilepsy drug which has numerous risks in pregnancy. What What Doctors Don’t Tell You doesn’t tell you is that these risks are well known and acknowledged. Official advice doesn’t just caution the use of Epilim in pregnant women, that is pretty common, it goes further and states that doctors should ensure any woman of childbearing age who is on the drug must take serious precautions to avoid pregnancy.