A popular medication for depressionand stress might be linked to lasting changes in the brains of children whose mothers used the medication during pregnancy.
A fetus's brain grows following a specific timeline. If this process is disturbed, leading to a developmental stage occurring either prematurely or delayed, it may affect the brain's structure and its ultimate functionality.
This misalignment in the brain's connections during critical developmental periods can result in weaknesses that might contribute to mental health or neurological conditions, even if the signs emerge only later in life.
Scientists from Italy and Finlandadministered the antidepressant drug, fluoxetineknown as Prozac, to pregnant and nursing rats and then observed their offspring.
The research discovered that male rats exposed to the drug while in the womb and female rats who received it through their mother's milk experienced alterations in genes responsible for key stages of brain development, resulting in a higher susceptibility to neurological and mental health issues later in life.
In male mice whose mothers were given fluoxetine during pregnancy, the critical period for brain development began earlier, and symptoms related to mood, like a reduced interest in enjoyable activities, were noted.
Female rats that were exposed from birth via breastfeeding exhibited a delayed period of opening and experienced memory issues later on.
Scientists discovered that the drug had its most significant effect in the hippocampus, the brain's main center for memory and emotional control. This could account for why those exposed experienced difficulties with memory and emotions later on.
These results were associated with biochemical modifications in the brain, particularly, modified genes that initiate and regulate the developmental timing in the hippocampus and other areas of the brain.
Therapies aimed at fixing this irregular timing might stop the conditions from arising in the first place, according to the researchers.
Pregnant female rats were split into three groups: the prenatal group was given fluoxetine in their water solely during pregnancy, whereas the postnatal group received fluoxetine while breastfeeding. The control group consumed plain water throughout.
When their children reached adolescence and later became adults, researchers performed a test to assess their enjoyment of a particular stimulus, namely sweetened water.
All the teenage rats, regardless of whether they had been given Prozac or not, acted normally. They favored the sugar water, indicating that their capacity to experience pleasure remained functional at this stage of life.
But in adulthood, the rats that were exposed to fluoxetine while in the wombThey lost their preference for the sugary solution. They consumed nearly equal amounts of plain water and sweetened water.
This new behavior, known as anhedonia, is a fundamental sign of depression. It indicates a decrease in the capacity to experience joy.
The drug use had altered their brain's reward mechanism, which remained unnoticed until they reached full maturity.
A different experiment exposed rats to two items they investigated and became accustomed to. Afterward, researchers substituted one of the known objects with a novel one to assess the rat's capacity to identify what it had previously encountered.
Rats that have strong memory should explore the new object more. As teenagers, all the rats functioned typically. Nevertheless, significant differences emerged once the rats reached adulthood.
In contrast to regular rats, female subjects that were exposed to the drug via their mother's milk showed no preference for a new object compared to an old one, suggesting an inability to create or retrieve memories.
Adult rats in the control group exhibited typical behavior and showed normal memory function.
Researchers determined that female offspring who were exposed to fluoxetine via their mother's milk experienced memory difficulties, whereas male offspring exposed during pregnancy showed a reduction in pleasure.
The scientists subsequently performed examinations on the rats' brains to observe alterations in brain structure and connections.
They identified the physical reason behind the changes in behavior. Early drug exposure had disrupted the brain's exact developmental programming.
Prolonged exposure to antidepressants interfered with the growth of crucial brain cells responsible for processing information, along with the protective systems that surround these cells, leading to difficulties in recognizing significant signals such as a known object or a pleasant flavor.
Researchers found that this process effectively reconfigured the male brain's response to depression and the female brain's capacity for memory, leading to a long-term susceptibility that only emerged during adulthood.
Antidepressants are typically considered safe throughout pregnancy. A 2020 study conducted in the United States found that antidepressants were taken in about one out of every 20 pregnancies during the first trimester.
One of the most frequently prescribed medications is fluoxetine. In total, 5.7 million Americans use this drug.
Fluoxetine is part of a group of drugs known as selective serotonin reuptake inhibitors (SSRIs), which enhance the brain's production of receptors that bind to serotonin, a crucial chemical involved in controlling emotions.
Serotonin transmits 'happy' signals between brain cells and is then reabsorbed. SSRIs prevent this reabsorption, causing more serotonin to stay active, which enhances communication and lifts mood.
Babies who are exposed to Prozac during pregnancy might develop temporary withdrawal symptoms such as shakiness and breathing problems, and have a slightly increased chance of being born prematurely, having a low birth weight, and experiencing possible heart complications.
However, for numerous pregnant women experiencing depression, the advantages of using an SSRI surpass the recognized dangers. Unaddressed depression poses considerable risks for both the mother and her child.
Unaddressed depression during pregnancy increases the likelihood of early delivery, low birth weight, and intrauterine growth restriction, a situation in which a baby fails to develop properly in the uterus.
It may also lead to issues as the child grows older. Children whose mothers have untreated depression aremore likely to strugglestruggle with impulse control, finding it hard to make friends, and encounter challenges in learning, behavior, and emotional regulation.
At the same time, the most recent research, released in the journalMolecular Psychiatry, indicates that using fluoxetine while pregnant might possibly affect a child's brain growth and raise their chances of developing mental health issues in the future.
Nevertheless, the scientists emphasize that these results, although alarming, must be validated through human research prior to affecting medical recommendations.
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