I read with interest about an article that suggests that there may be a causal relationship between the use of SSRI (selective serotonin reuptake inhibitors) drugs in pregnant women and the likelihood of their giving birth to a child with autism. Apparently, in a group of women, there seemed to be an increase of about 3% in the risk of her having an autistic offspring than someone who either had no depression or other mental condition or a person with the condition who had not used SSRI drugs. Lead author and Kaiser Permanente epidemiologist Lisa Croen has stated that caution should follow interpretation of the results as they are preliminary and more research will have to be done to see if this could be something contributing to the etiology of autism.
I tried to download the primary source and a commentary on it in the same journal. Unfortunately, they were behind a paywall and I could not obtain them for free. As far as I can tell, no reason how the SSRI could have caused the fetus to become autistic was given.
Though I was unable to read the actual article itself, the story about it interested me for two reasons.
First of all, my maternal grandmother suffered from severe depression well before the days of SSRI drugs. She underwent ECT and ultimately committed suicide at age 49 a couple of years before I was born. I suspect that her genetics may have been a factor in my disability, as well as some ADD traits in a couple of my cousins who are also her grandchildren. Though it sounds like Croen and colleagues did make some attempt to control for genetics of the mental illness, I can't help thinking that it was the mother's depression itself that caused a genetic predisposition to the autism, rather than the ingestion of the drugs being toxic to the fetus.
The second reason the story piqued my interest was that some may remember that Lisa Croen's main claim to fame was her faux pas in publishing some interpretations from CDDS data that suggested to her that the reason for the greatly increased prevalence of autism was due to 100% diagnostic substitution of mental retardation for autism, claiming that there was a corresponding decrease in mental retardation diagnoses to the increase for autism diagnoses. The problem, apparently, with her interpretation was that she did not adjust for age of admission into the CDDS which was very different for persons with retardation than for autism. Mark Blaxill, well-known for his beliefs that vaccines caused his daughter and other children to become autistic, showed that she had misinterpreted her data. Croen later, admitted to the mistake. Whether or not this reduces the credibility of Croen's interpretations of the data in her current study I don't know.
As many persons interested in autism now know, recently there was a study suggesting that the environment may play a greater role than thought in autism. Now that the vaccine hypothesis has been refuted in a variety of studies (regardless of whether or not these studies are in fact tobacco science as some die hard proponents of the vaccines-cause-autism camp state), there is apparently a temporal relationship (though not a casual relationship) in terms of a timeline between the advent of SSRI drugs and increases in autism diagnoses. I have shown elsewhere that there is not a temporal relationship between increases in thimerosal and increases in autistic persons admitted to the CDDS. Whether this is true for all vaccines, which don't contain thimerosal such as the MMR, which could factor into the equation, I don't know.
The temporal relationships between introducing autism as a diagnostic category in 1991 under IDEA and then supreme court decisions favorable to those seeking services for their autistic children and increases in diagnoses have been largely ignored by the public interested in developmental disabilities which sees special education and the IDEA law as a quick fix for their kids problems.
Is it possible that SSRI drugs will be the new factor that those who claim there has actually been an increase in autism will claim is responsible? I don't know. Only time will tell.