Hong Kong researchers this week confirmed in the Lancet Psychiatry, that mothers using antidepressants during pregnancy do not increase their child’s risk of developing autism or ADHD.
In a systematic review of existing published, the researchers probed 37 published studies to assess the evidence in favour of claims that there is a link between SSRIs and these neurodevelopmental conditions. The team based out of the University of Hong Kong performed a meta-analysis of the combined data of the 37 studies comprising over 600,000 pregnant women using antidepressants. They found no evidence for a causal link to either condition.
Author Dr Wing-Chung Chang Told the Lancet. ‘We know many parents-to-be worry about the potential impact of taking medication during pregnancy; our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders such as autism and ADHD in children. While all medications carry risks, so too does stopping antidepressants during pregnancy due to an increased risk of relapse. Therefore, for women with moderate-severe depression, doctors and patients must carefully weigh the potential risks and benefits of continuing antidepressant treatment during pregnancy against the potential harms of untreated depression,’
he went on,
‘Although our study found a small increase in the risk of autism and ADHD in the children of women who had used antidepressants during pregnancy, it also found that this risk disappeared when we accounted for other factors. The increased risk was also seen in the children of fathers who took antidepressants and of mothers with antidepressant use before, but not during, pregnancy. Together, this suggests that it is not the antidepressants themselves causing an increased risk in autism and ADHD but it is more likely to be due to other factors, including genetic predisposition to conditions such as ADHD, autism, and mental health conditions.’
The team compared out comes of 600,000 pregnant women who used antidepressants to 125 million women who didn’t use antidepressants. SSRIs showed no significant association with autism or ADHD once confounding factors were taken into account, but they did see a small link with amitriptyline/nortriptyline. Amitriptyline/nortriptyline is usually prescribed for treatment-resistant severe depression.
Anxiety and /or depression in adults with autism or ADHD are not unusual. A 2026 NHS cohort study observed that 40% of autistic participants had been diagnosed with anxiety and 62% had a past or current depression diagnosis. Previous studies analysed in a 2018 systematic review had put the numbers at up to 42% for anxiety disorders and between 23 and 37% for depressive disorders. In the past other medication, such as paracetemol/acetominophen have been linked to autism, with subsequent studies showing that the link was more likely indirect with parents with autistic traits being the biggest risk factor for a diagnosis.
Lisa Vitte, Emmanuel Devouche and Gisele Apter from University Rouen Normandy, France, who were not involved in the study, told the Lancet, ‘Chang and colleagues’ study adds knowledge and confirms some of the pre-existing knowledge on the use of antidepressants during pregnancy: that they should continue to be taken as they protect maternal mental health and do not harm fetal development. This result is of considerable impact after many contradictory and controversial studies.’
Last week the US health agency put out a press release announcing they would be discouraging use of antidepressants, in particular SSRIs. The embattled head of the agency has a track record of making unsubstantiated claims regarding links between prenatal SSRI exposure and autism spectrum disorder.
Cliffe C, Rees H, Childs H, et al. Sex differences in mental health disorders among autistic men and women: retrospective service audit of a random cohort. BJPsych Bull. Published online April 7, 2026:1-5. doi:10.1192/bjb.2026.10217
Hollocks MJ, Lerh JW, Magiati I, Meiser-Stedman R, Brugha TS. Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis. Psychological Medicine. 2019;49(4):559-572. doi:10.1017/S0033291718002283
