Antidepressant Use During Pregnancy Can Impact Fetal Brain Development

A study recently published in Nature Communications has presented evidence that antidepressant use during pregnancy can impact the development of a child’s brain, increasing the risk of mental health disorders later in life.

The study, led by researchers at the University of Colorado Anschutz Medical Campus, focused on the effects of fluoxetine, commonly used in medications such as Prozac and Sarafem, for treating depression, perinatal depression, and anxiety on the developing prefrontal cortex.

The researchers studied the impact of serotonin, which is increased by fluoxetine, on the development of the prefrontal cortex in a fetus, as this brain region is responsible for the highest-order cognition.

Won Chan Oh, Ph.D., the study’s lead author, said that while serotonin plays a role in brain development, the mechanisms behind its influence in the prefrontal cortex have been unclear until now. 

The researchers found that serotonin is not only involved in overall brain function but also has a specific role in forming and adapting individual connections between neurons, which is crucial for the brain’s ability to learn and adjust. They discovered this by studying the impact of both deficiency and surplus of serotonin on brain development in mice.

The study also showed that fluoxetine crosses the placenta and passes into breast milk, which means that serotonin is transferred from the mother to the baby.

The study found that once in the baby, it “increased the density and strength of excitatory synapses.” 

“Disbalances of 5-HT (serotonin) during brain development are associated with increased risk of neurodevelopmental disorders such as autism spectrum disorder and long-lasting behavioral deficits,” the study reported.

Since serotonin regulation is thought to play a major role in mood disorders, such as anxiety and depression, prenatal use of antidepressants could be a factor in the development of these disorders in the mother’s children.

The researchers hope their findings will lead to early interventions and the development of new therapeutics for neurodevelopmental disorders involving serotonin dysregulation.

They suggest that healthcare professionals should be involved in decision-making around individualized care for pregnant women, including discussing the benefits and side effects of antidepressants and possible non-pharmacological interventions for anxiety and postpartum depression. 

The researchers plan to continue studying the impact of fluoxetine, next examining its effect on the developing teenage brain.

Related Articles:

• Antidepressant Use During Pregnancy Increases Autism Risk By 87 Percent
• Antidepressant Use During Pregnancy Can Affect Newborn Brain Activity

Reference

Ogelman R, Gomez Wulschner LE, Hoelscher VM, Hwang IW, Chang VN, Oh WC. “Serotonin modulates excitatory synapse maturation in the developing prefrontal cortex.” Nature Communications, 16 February 2024.