Use of Antidepressants During Pregnancy and Risk of Autism Spectrum Disorder

To determine the correlation between the use of antidepressants during pregnancy and the child being born with autism spectrum disorder, a group of researchers looked at infant and mother data in Quebec from 1998 to 2009. From looking at his data, they collected 145,546 infants born to mothers who were covered by Regie de l’assurance maladie du Quebec for at least a year prior to and throughout their entire pregnancy. They determined that use of an antidepressant was established by the filling of at least one prescription throughout their pregnancy. By the end of their study, with the children having a mean age of six, 1,054 children had been diagnosed with autism spectrum disorder. The women who had used antidepressants, specifically those using selective serotonin reuptake inhibitors in the second or third trimester, had a much higher frequency of giving birth to a child whom would be diagnosed with at least one diagnosis of autism spectrum disorder.

Identifying a potential cause or contributor to the autism spectrum disorder can create a great sense of caution among future mothers. When making people aware of the concern and issue of using antidepressants, it becomes a much stronger argument when you have data and research to back up the claim. Hopefully in the future, mothers will become more aware of their impact on children with the prescription medications they take and will be able to plan accordingly.

As medical professionals should we be able to restrict the access that pregnant women have to antidepressants as it poses a risk to their unborn child?

JAMA Pediatr. 2016;170(2):117-124.

Using tuberous sclerosis to treat autism spectrum disorder

Autism spectrum disorder is a neurodevelopmental disorder that first becomes present in children under three years of age. Autism spectrum disorder (ASD) typically presents with effects such as learning disabilities, social impairment, and behavioral shortcomings. These symptoms present differently in different patients depending on the level of severity of the patient’s disorder. Currently, there are only two medications that are FDA approved to help patients with behavioral impairments caused by AD: risperidone and aripiprazole. Tuberous sclerosis complex (TSC) is a genetic disorder that results from the loss of the TSC1 or TSC2 genes. Loss of either of these genes leads to the upregulation of the mTOR pathway. These are used to help normal dendritic, axonal, and synaptic development. Patients with TSC have abnormal neural connectivity which can ultimately lead to symptoms identical to ASD.

Davis, et al. sought out to review a method to treat the symptoms of ASD by treating the symptoms of TSC, since 90% of patients with TSC also develop some type of tuberous sclerosis-associated neuropsychiatric disorder which includes ASD. In the reviewed studies, mTOR inhibitors were used to regulate the mTOR pathway in hopes of regulating neural development in mice. The mTOR inhibitor investigated was rapamycin. It was shown to correct for the mutated developmental mechanism associated with the behavioral and learning disabilities of those with ASD.

This review proposes a mechanism that can be used to treat the symptoms of ASD. mTOR inhibitors are shown to be useful in mice to manage the behavioral and learning symptoms of ASD that result from TSC. Using this mechanism opens many doors into the treatment of a disorder that effects 1 in every 68 children in America. These doors have the potential to help a significant amount of people with varying levels of ASD which will lead to more people living normal lives both behaviorally and socially.

Neurotherapeutics. 2015; 12:572-583.

Oxytocin for Male Subjects with Autism Spectrum Disorder and Comorbid Intellectual Disabilities: A Randomized Pilot Study

Individuals who are the autistic spectrum also have a high likelihood of suffering from co-morbid intellectual disabilities (ID).  Oxytocin (OXT) receptors play a likely role in excitatory/inhibitory responses in humans.  This study that Oxytocin can be given therapeutically to increase social interaction in individuals on the autistic spectrum.  This study’s purpose was to determine the effectiveness and adverse effects of intranasal OXT.  29 males (age 15-40) were tested in a double blind, placebo-controlled study.  This is simply a pilot study.

The conclusion of the study was that there is reason for future multi-center clinical trials to determine further the efficacy of OXT on individuals with ASD and ID to determine if social interactions differ and improve.  There was a correlation between plasma OXT levels and levels of social interactions between the men studied.  

This is important because it is calling for long-term clinical trials of OXT plasma levels effects on social interactions.   This is a possible way to treat those on the autistic spectrum and increase their ability for social interaction thus making their quality of life improve drastically.  This is interesting that a simple Oxytocin imbalance could help to treat these individuals.  

Munesue T, Nakamura H, Kikuchi M, et al. Oxytocin for Male Subjects with Autism Spectrum Disorder and Comorbid Intellectual Disabilities: A Randomized Pilot Study. Frontiers in Psychiatry. 2016;7:2. doi:10.3389/fpsyt.2016.00002.