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Meds Disturb Motor Development

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Science Translational Medicine  06 Jun 2012:
Vol. 4, Issue 137, pp. 137ec99
DOI: 10.1126/scitranslmed.3004397

The use of medications to treat mental health disorders has increased dramatically in recent years. But little is known about the long-term effects of such drug exposure during the earliest period of development: in the womb. Scientists are still in the process of deciphering the mechanisms by which psychotropic medications exert their effects on the brain during and after development. Meanwhile, the therapeutic applications of antipsychotic medications have expanded beyond treatment of psychoses. For example, women of child-bearing age now use these medications as treatments for depression, anxiety, and mood dysregulation. Antipsychotic medications cross the placenta, and clinical and preclinical studies have associated their use in pregnancy with brain structural and functional changes in offspring. Given the widespread use of these medications and the dearth of studies in human subjects, Johnson et al. sought to examine whether intrauterine antipsychotic exposure is associated with deficits in neuromotor performance in 6-month-old infants.

These researchers tested pairs of mothers and their infants, 6 months after birth, who had exposure during pregnancy to antipsychotics, antidepressants, or no psychiatric medications. Examiners who were blind to maternal–infant exposure status administered to the infants a standardized neuromotor examination—the Infant Neurological International Battery (INFANIB)—that tests posture, tone, reflexes, and motor skills. After controlling for important covariates such as the ages of the mother and infant and the mother’s marital status, Johnson et al. found that infants who were prenatally exposed to antipsychotics showed significantly lower INFANIB scores than did those who had antidepressant or no medication exposure. The INFANIB scores were also significantly associated with maternal psychiatric history, including depression, psychosis, and overall severity and chronicity of these disorders.

This study indicates that among 6-month-old infants, a history of intrauterine antipsychotic exposure may influence neuromotor performance. This finding underscores the importance of conducting additional studies designed to define the neurodevelopmental sequelae of fetal antipsychotic exposure. The current study is limited by a small sample size of infants prenatally exposed to antipsychotic medications and demographic homogeneity of the cohort studied, both of which prevent generalizability. Despite these limitations, research of this kind likely will illuminate early factors that influence the neurodevelopmental trajectories of offspring whose mothers require antipsychotic therapy during gestation.

K.C. Johnson et al., Prenatal antipsychotic exposure and neuromotor performance during infancy. Arch. Gen. Psychiatry 2 April 2012 (10.1001/archgenpsychiatry.2012.160). [Abstract]

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