ok let's discuss the study about SSRIs/autism

[pugz]

the original article: www.nbcconnecticut.com/news/health/Antidepressants-in-Pregnancy-Linked-to-Autism-in-Kids-361854151.html



A response that calls out the motivations of one of the study co-authors:

www.slate.com/articles/health_and_science/medical_examiner/2015/12/antidepressants_in_pregnancy_probably_do_not_cause_autism.html

[Deleted]

I'm very curious what the reviewers at JAMA Peds have to say about this.

[aspentosh]

Correlation does not imply causation.

This is one of the first things you learn as a scientist and I swear it seems like 90% of researchers forget this simple fact.

[pugz]

Dec 17, 2015 9:48:55 GMT -5 @sessalee said:

I'm very curious what the reviewers at JAMA Peds have to say about this.

looks like there was an editorial about it in the same edition the study was published


archpedi.jamanetwork.com/article.aspx?articleid=2476185

[Deleted]

Dec 17, 2015 9:50:50 GMT -5 pugz said:

Dec 17, 2015 9:48:55 GMT -5 @sessalee said:

I'm very curious what the reviewers at JAMA Peds have to say about this.

looks like there was an editorial about it in the same edition the study was published


archpedi.jamanetwork.com/article.aspx?articleid=2476185

LOL you should have labeled this "LMGTFY". Thanks

[Deleted]

Dec 17, 2015 9:50:34 GMT -5 @this said:

I don't actually know if they're the same.

TBH I didn't read the article. LOL

I accept science. I just care more about important things like my confessions thread getting deleted.

If you are really this upset then let's talk off board. Yes, opaque tights are very confusing for a lot of people.

[kershnic]

This is driving me crazy. JAMA Pediatrics is a top medical journal, they don't just publish bullshit.

Media reporting on science makes me want to throw things.

Here's a Washington Post article with a lot more information than the NBC blurb.
www.washingtonpost.com/news/to-your-health/wp/2015/12/14/maternal-exposure-to-anti-depressant-ssris-linked-to-autism-in-children/

[runblondie26]

They seem to focus on SSRI's. What abut other classes of anti-depressants?

[VillainV]

Pretty much every doctor's response I've heard/read has been that it's MUCH riskier for the mom to go off anti-depresants (or not take them if they are needed) than the potential increased risk of autism (if, in fact, it does exist).

And? It kind of pisses me off that people are talking about autism like it's some horrible awful thing*. It makes me feel really bad for my friends who have kids on the spectrum -- kids who are smart, happy, friendly, and will most likely be very productive and valuable members of society. I don't have a kid on the spectrum, so I don't know how difficult it is, and I don't want to invalidate that at all. It's just the way some people talk, people with Autism shouldn't exist, and I think that's pretty offensive.

ETA:   I realize this didn't sound like how I meant it.  Yes, Autism affects LOTS of families and should be studied, and we should do whatever we can to try to understand it better.   It just bugs me when people talk like it's SO bad that we should do stupid stuff (like NOT VACCINATE or STOP ANTIDEPRESSANTS) in order to avoid having a kid with a non-life-threatening disease.

[Brie]

I took Zoloft through my whole pregnancy with P. He has a significant brain injury.

I'd do it again in a heartbeat.

[water*drop]

Disclaimer: I've only skimmed and am in grading hell right now, so I don't have time to read fully. I'm not going to comment on the study results because I don't feel like I can do that accurately without more time to read.

I think, like pretty much all studies that manage to get through peer review, it's worth researching further. The sample size is small, an author may have questionable motivations, etc, so that's about as much weight as I would give it - like, hey, there are results here that make this worthy of additional research. I wouldn't make an actual medical decision based on this study, but if this were my area of research, I'd definitely consider using it as a starting point for my next project.

I also think that it's SO IMPORTANT for the media to get this shit right. Don't overstate the results, do disclose potential conflicts of interest right off the bat, make sure you've got somebody well-versed in experimental design, statistics, etc, as your science journalist (and actually HAVE a science journalist since that's a real field now). The average citizen isn't going to read the full study, and even if they do, they aren't trained in the content, so it's not fair to expect them to understand it fully. If the media is going to act as the middle man, they need to get it right and not just write the headlines/articles to get clicks.

Edited to make a massive run-on sentence at least a little more grammatically correct.

[kershnic]

Dec 17, 2015 9:49:02 GMT -5 @this said:

There's a small risk in taking ADs while pregnant.

JUST LIKE THERE'S A RISK OF EATING A SUBWAY SANDIWCH AND GETTING LISTERIA.

lol

In terms of what individual pregnant women should do, it's the same.  But in terms of what it means for science, it's completely different.  Autism is a huge fucking mystery and any science that makes meaningful progress in understanding what causes Autism is hugely important.

[Deleted]

This article seriously stresses me out, not that I think we shouldn't post about it BUT - I used ADs during 3rd tri, I'm AMA, and I have 2 boys. I'm pretty much fucked aren't I?

(side question pugz is Zoloft an SSRI, I think it is?)

[Deleted]

It's hard when you've already engaged in the risky behavior now under scrutiny and are basically waiting on the results. The scary thing about autism is that no one really knows what causes it and tons of factors have been considered over the years. Probably a lot of different things can act as an environmental trigger for a genetic component. If you did take ADs during your pregnancy and your child is diagnosed with autism, it will be hard not to blame yourself. I'm not saying we should not discuss it. But I don't think we should pretend that people have no right to be sensitive about it or that people who are sensitive are all "I hate science."

[kershnic]

Dec 17, 2015 9:50:02 GMT -5 aspentosh said:

Correlation does not imply causation.

This is one of the first things you learn as a scientist and I swear it seems like 90% of researchers forget this simple fact.

Yes, but causation is really fucking hard to prove, and we have ethics so research on real world problems almost always has to be done in roundabout ways with multiple studies looking at the same issues from different approaches and eventually the evidence all points in the same direction.  We can't randomly assign a group of pregnant women to take SSRIs in pregnancy and see what happens.  Who wants to sign up for that study??  Not happening.

[Deleted]

Dec 17, 2015 9:53:32 GMT -5 kershnic said:

Media reporting on science makes me want to throw things.

Yes I agree and I will read the article you posted, thank you.  It frustrates me that for every 100 people who see the article pop up over and over again on FB one person will make an uninformed decision not to take SSRIs and maybe 10 or more will judge someone who does. The same thing happens every time there's an article about a daycare working doing harm. Cue dozens of comments like "this is why I don't trust anyone etc." Really FB is just horrible.

[jeaniebueller]

Dec 17, 2015 9:50:42 GMT -5 gravytrain225 said:

Is anyone else watching Adam Ruins Everything? He talked this week about how easy it is to get garbage sconce posted. That said, I haven't read either article yet.

It is! Its a huge issue in the area of child abuse.

[pugz]

@envino it is an SSRI.

The media ALWAYS leads with the "findings" of a study even if it's a flawed study or has a very small sample size or other compounding factors. I hate that because people take article headlines as facts.

[laurack]

I think further research is warranted and I think it's great they are researching it. As of now, obviously it's not a strong enough link for people who have depression and anxiety to just stop taking their medications.

It doesn't seem that alarming to me. There was a study recently I believe that suggested being under 20 or over 40 when pregnant also was a risk factor for autism.

Like with all medications during pregnancy, there is a risk benefit analysis to be done. Scientific evidence emerges over time that determines certain medications were not actually safe at all. But until that happens we have to put our trust in the medical community? If my midwife tells me that it is safe to take Zantac for heart burn during pregnancy, then it turns out its not safe what can be done, it's too late and I can't blame myself or my midwife? You follow current recommendations and the advice of your prenatal care provider. If going into a pregnancy my midwife said "new research concludes you should NOT TAKE ZANTAC WHILE PREGNANT" then I wouldn't take it.

I don't know. I guess I'm in support of scientific research but against the judgment of women who continue to take certain medications despite a possible 0.01% risk of whatever

[Deleted]

I was very excited the article was like " Oh there is minimal risks BTW" so I liked it.

Should I put on the flame retardant suit now ..... or later....

[Deleted]

The change in risk was from 1% to like 1.86%.

It's interesting, but not earth shattering for me. Of course, I'm done having kids so the fact that I'm now hooked on Zoloft isn't a problem for me.

[matildasun]

There was an article on NPR discussing the study, and it said that depression itself was also a possible factor. I will try to find it later.

[aspentosh]

Dec 17, 2015 10:00:04 GMT -5 kershnic said:

Dec 17, 2015 9:50:02 GMT -5 aspentosh said:

Correlation does not imply causation.

This is one of the first things you learn as a scientist and I swear it seems like 90% of researchers forget this simple fact.

Yes, but causation is really fucking hard to prove, and we have ethics so research on real world problems almost always has to be done in roundabout ways with multiple studies looking at the same issues from different approaches and eventually the evidence all points in the same direction.  We can't randomly assign a group of pregnant women to take SSRIs in pregnancy and see what happens.  Who wants to sign up for that study??  Not happening.

No, but you can do a longitudinal study of women that are already taking them alongside another group that is not taking SSRIs or other types of ADs. 

There are ways to do studies that people wouldn't want to do. My lab did them. And we paid people a lot of money to do it, so it was worth it to them.

[Deleted]

Dec 17, 2015 9:59:14 GMT -5 CheeringCharm said:

It's hard when you've already engaged in the risky behavior now under scrutiny and are basically waiting on the results. The scary thing about autism is that no one really knows what causes it and tons of factors have been considered over the years. Probably a lot of different things can act as an environmental trigger for a genetic component. If you did take ADs during your pregnancy and your child is diagnosed with autism, it will be hard not to blame yourself. I'm not saying we should not discuss it. But I don't think we should pretend that people have no right to be sensitive about it or that people who are sensitive are all "I hate science."

Yes. This is my point. Old lady having boys and taking ADs. As if I don't have enough to blame myself for already?

[kershnic]

Dec 17, 2015 10:00:55 GMT -5 @notquiteblushing said:

Dec 17, 2015 9:53:32 GMT -5 kershnic said:

Media reporting on science makes me want to throw things.

Yes I agree and I will read the article you posted, thank you.  It frustrates me that for every 100 people who see the article pop up over and over again on FB one person will make an uninformed decision not to take SSRIs and maybe 10 or more will judge someone who does. The same thing happens every time there's an article about a daycare working doing harm. Cue dozens of comments like "this is why I don't trust anyone etc." Really FB is just horrible.

I just want to say to you NQB I'm sorry this whole thing has resulted in some mud throwing at you.  I took an SSRI in 3rd trimester too, so I have personal feelings about this research too.  I understand that it's anxiety provoking.  The media sucks at reporting on science and random people suck even worse at interpreting it.  

[laurack]

Dec 17, 2015 10:03:04 GMT -5 @tokenhoser said:

The change in risk was from 1% to like 1.86%.

It's interesting, but not earth shattering for me. Of course, I'm done having kids so the fact that I'm now hooked on Zoloft isn't a problem for me.

that's an EIGHTY SIX PERCENT RISK INCREASE!!!!!

this reminds me of the cured meat is bad thing recently actually. At first the numbers seemed alarming. Then I read more and dismissed it completely, continuing to chow down on delicious bacon

[Deleted]

Dec 17, 2015 10:08:35 GMT -5 laurack said:

Dec 17, 2015 10:03:04 GMT -5 @tokenhoser said:

The change in risk was from 1% to like 1.86%.

It's interesting, but not earth shattering for me. Of course, I'm done having kids so the fact that I'm now hooked on Zoloft isn't a problem for me.

that's an EIGHTY SIX PERCENT RISK INCREASE!!!!!

this reminds me of the cured meat is bad thing recently actually. At first the numbers seemed alarming. Then I read more and dismissed it completely, continuing to chow down on delicious bacon

Exactly.

Given the risks of NOT taking antidepressants, I hope most women know that it's not a cut-and-dry decision. Like, the risks of a bacon-free life are non-negotiable for me. 

[juliette21]

What if it's the underlying medical health condition of depression/anxiety that is causing the higher risk for autism? I don't know if they evaluated that yet, but I always wonder about the chicken-egg thing. Women who take SSRI's in pregnancy suffer from depression and/or anxiety, and therefore already have altered brain chemistry and/or genes for that.

My theory is that autism is an inherited combination of genetics that are all working together in the "wrong" way.

[curbsideprophet]

The first article linked does not actually say pregnant women should stop taking ADs. Does the full JAMA piece say this?

The research may be questionable ( I have no idea) but the Slate article seems to be misleading as well.

[juliette21]

Dec 17, 2015 10:05:12 GMT -5 matildasun said:

There was an article on NPR discussing the study, and it said that depression itself was also a possible factor. I will try to find it later.

This is what I was saying, but I didn't hear the NPR discussion. Interesting, I would love to read that.