Articles reporting negatively on antidepressants should come with a huge disclaimer to those taking them that they should continue to do so unless their doctor / psychiatrist recommends otherwise.

It seems obvious, but after being mostly depression / anxiety free for four years and reading an influx of articles claiming that they do nothing or very little based on new research, I decided to quit. Huge mistake that very nearly ruined my life.

It turned out that despite all the lifestyle changes I made as well as therapy I received to mitigate depression and anxiety, the pills were almost solely responsible for my recovery. Restarting the SSRI of course did the trick, but they don't work fast and I lost nearly a year of my life. I currently regard this as the worst decision I have ever made.

This article is very one-sided. It's simply an interview with the author of the paper. I would very much like to see what other experts in the field are saying, especially because I think the causation claims here are pretty bold for a register-based study.

Also, this: "Our study is not out to scare women" in the same interview as "We have to remember that thalidomide was labeled as 'safe' for use during pregnancy." If you're bringing up thalidomide, you're absolutely out to scare women. It's like Godwin's Law for discussions about drugs in pregnancy.

Actually, it's a misleading title. There's association, but there's no proven causation. Here's the quote:

>This study is consistent with other studies on the same research question. Each study is observational because randomized controlled trials are not ethically possible during pregnancy. Hence, each study is describing an association. The accumulation of such findings will lead to causation

It's observational study, i.e. a study which can only show association. You can easily think of many reasons why you might get such a result. For example, depression and autism might have overlapping genes, and having such gene, results in depression in mother and higher risk of autism in a child.

> I would always be very cautious about saying that anything is 'safe' during pregnancy. We have to remember that thalidomide was labeled as 'safe' for use during pregnancy.

Holy shit if it isn't manipulative. The most charitable reading, after skimming[0], still says the risk increased from "most likely not going to happen to you" to "still most likely not going to happen to you".

I'd like to see some absolute values please.

[0] - https://en.wikipedia.org/wiki/Epidemiology_of_autism

1.5% inherent * 187% from pills = 2.8% risk of autism.

Risk of having started a course of antidepressants for absolutely no reason = ~0%

Articles with headlines like these seem manufactured to lead the statistically ignorant into bad decisions. Clickbait science.

It's important to be aware of the absolute risk even when the relative increase is 87%. In this case the risks are always below 1.5%. I haven't read the paper, but the presence of depression (rather than the SSRIs) could also be a cause for the increase. They might want to look at depressed pregnant women who are treated with alternatives to try to deal with that confounding factor.

Suicide is the leading cause of death of mothers in the perinatal period, so I'm glad they said that talking therapies are important.

They present this increased risk as a percentage. No-one understands what that means. People can't translate that increase in risk into actual numbers of people with autism.

In the interview, they state that "the rise in autism...".

That's been shown to be fallacious. Autism is only really a very recent diagnosis, and reporting rates were either low or the condition wasn't diagnosed properly.

Then the author hypothesises that the seratonin levels might be what causes the issues with autism. But those taking SSRIs have a problem with seratonin levels already, right? So how do they know it's the anti-depressant?

I read the comments when study was posted to HN previously, but there doesn't seem to be too much questioning of the the study itself. Perhaps I'm being unfair.

This study has been criticised - I think NOR gives a pretty balanced report here:

http://www.npr.org/sections/health-shots/2015/12/14/45966593...

There is a good rule of thumb to use when looking at associative studies - if the effect is not 300% or more then it is unlikely to hold up when tested in a double blind study. Anything under 3 fold is mostly noise or bad experimental design.

As a comparison the risk of lung cancer is 1500% higher in smokers than non-smokers.

What are the absolute figures? A relative figure is meaningless (or, at least/highly misleading) if the original chance was miniscule.

The linked article claims "antidepressants increase risk". Linked JAMA article plainly says "association".

Sure they eliminated a couple of known associations, which is good. But this isn't a slam dunk cause->effect, particularly since some studies have shown no association.

> Randomized controlled trials have also shown that exercise or psychotherapy are valid treatment options

The research on exercise is rather inconclusive (mostly because it's hard to placebo-control exercise, but see e.g. [1] for an interesting attempt), and I don't know of any trials that demonstrate the validity of switching away from a working depression treatment. The chances of success are generally not great when trying a new depression treatment (~30% for the first one, decreasing with each failed treatment [2]), so I'm not convinced that the validity alluded to here actually translates into any actionable advice in the context of this study.

[1] http://www.ncbi.nlm.nih.gov/pubmed/21037212

[2] http://www.edc.gsph.pitt.edu/stard/

Reporting an increase of a percentage of risk is horribly misleading.

I hate to be the one, but I wonder if Jenny McCarthy is looking into this research as a possible alternative explanation for what she went through.

Nobody has mentioned in addition to drugs, talk therapy, food can be a lifesaver wrt depression. Specifically, I and a medical doctor had the same experience that taking fish oil, ie high quality omega 3 DHA/EPA was a lifesaver. Also getting off sugar+ is a huge change to the brain's chemical load.

Antidepressents are just a vaccine for depression, anti-vaxxers standpoint confirmed /s