Clinical Guidance: Mother’s Depression, Not Prenatal Antidepressants, Affects Young Children
Children of depressed mothers who stop taking antidepressants before pregnancy have IQs and rates of behavioral problems similar to those of children of mothers who take serotonin reuptake inhibitors or venlafaxine, a serotonin-norepinephrine inhibitor, during pregnancy. Nulman et al. (p. 1165) tested children at age 3–6 and report that IQs are lower in these children than in children of nondepressed mothers, and behavioral problems are somewhat more common (figure). However, neither difference is related to prenatal antidepressant dose or duration. The child’s IQ is influenced by the mother’s IQ and child’s sex. Behavioral problems are associated with the severity of the mother’s depression not only during gestation but also during early childhood. The editorial by Steiner (p. 1130) summarizes evidence that untreated depression is a larger threat to offspring than antidepressants, but he recommends medication during pregnancy only if the indication is compelling.