Many but not all studies suggest that gestational exposure to antidepressant drugs is associated with an increased risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring. All of these studies have been observational in design, and observational research may suggest but cannot establish cause-effect relationships. In this context, a recent, large, population-based, observational study found that exposure to maternal depression before, during, or after pregnancy was each associated with an increased risk of ASD as well as ADHD. Strikingly, the same finding was obtained for paternal depression, as well, with mostly similar values for risk. If paternal depression before, during, or after pregnancy can increase the risk of ASD and ADHD in the offspring, it suggests that genetic variables, or environmental adversities engendered by behaviors related to paternal depression, may drive the risk for the adverse neurodevelopmental outcomes; some data exist to support this view. An understanding of these possibilities allows greater room for flexibility when considering the prescription of antidepressant drugs to depressed pregnant women.
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