Serotonin Hypothesis of Autism

Implications for Selective Serotonin Reuptake Inhibitor Use during Pregnancy

Rebecca A. Harrington, Li Ching Lee, Rosa M. Crum, Andrew W. Zimmerman, Irva Hertz-Picciotto

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Serotonin, a neurotransmitter found throughout the brain and body, has long been of interest in autism. Repeated findings of elevated platelet serotonin levels in approximately one third of children with autism has led some to believe that dysfunctional serotonin signaling may be a causal mechanism for the disorder. Because serotonin is critical to fetal brain development, concerns have arisen regarding prenatal exposure to substances that manipulate serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs). This review examines evidence regarding the serotonin system and autism spectrum disorders (ASD), as well as what the literature has reported thus far on developmental effects of prenatal exposure to SSRIs. Possible mechanisms by which SSRIs could affect the fetus during pregnancy and clinical implications are also discussed. Though the majority of studies conducted in infants and children suggest prenatal exposure to SSRIs does not affect neurodevelopment, interpretation must be tempered given small sample sizes. The only published study that focused on prenatal SSRI exposure and ASD found an increased risk with exposure to SSRIs, especially during the first trimester. Obstacles that will be faced in future research are isolating medication effects from maternal depression and, given the infrequent occurrence of exposure and outcome, obtaining an adequate sample size. Whether serotonin is an etiologic factor in ASD, and what it points to as a marker for subgrouping, remains unclear. Understanding how the development of ASD might be affected by prenatal factors that influence serotonin levels, such as SSRIs, could identify modifiable targets for prevention.

Original languageEnglish (US)
Pages (from-to)149-168
Number of pages20
JournalAutism Research
Volume6
Issue number3
DOIs
StatePublished - Jun 2013

Fingerprint

Serotonin Uptake Inhibitors
Autistic Disorder
Serotonin
Pregnancy
Sample Size
Brain
First Pregnancy Trimester
Fetal Development
Neurotransmitter Agents
Fetus
Blood Platelets
Mothers
Depression
Autism Spectrum Disorder

Keywords

  • Autism spectrum disorders
  • Pregnancy
  • Selective serotonin reuptake inhibitors
  • Serotonin

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Genetics(clinical)

Cite this

Serotonin Hypothesis of Autism : Implications for Selective Serotonin Reuptake Inhibitor Use during Pregnancy. / Harrington, Rebecca A.; Lee, Li Ching; Crum, Rosa M.; Zimmerman, Andrew W.; Hertz-Picciotto, Irva.

In: Autism Research, Vol. 6, No. 3, 06.2013, p. 149-168.

Research output: Contribution to journalArticle

Harrington, Rebecca A. ; Lee, Li Ching ; Crum, Rosa M. ; Zimmerman, Andrew W. ; Hertz-Picciotto, Irva. / Serotonin Hypothesis of Autism : Implications for Selective Serotonin Reuptake Inhibitor Use during Pregnancy. In: Autism Research. 2013 ; Vol. 6, No. 3. pp. 149-168.
@article{8a717bf0f4a34166b717e29967ac84c7,
title = "Serotonin Hypothesis of Autism: Implications for Selective Serotonin Reuptake Inhibitor Use during Pregnancy",
abstract = "Serotonin, a neurotransmitter found throughout the brain and body, has long been of interest in autism. Repeated findings of elevated platelet serotonin levels in approximately one third of children with autism has led some to believe that dysfunctional serotonin signaling may be a causal mechanism for the disorder. Because serotonin is critical to fetal brain development, concerns have arisen regarding prenatal exposure to substances that manipulate serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs). This review examines evidence regarding the serotonin system and autism spectrum disorders (ASD), as well as what the literature has reported thus far on developmental effects of prenatal exposure to SSRIs. Possible mechanisms by which SSRIs could affect the fetus during pregnancy and clinical implications are also discussed. Though the majority of studies conducted in infants and children suggest prenatal exposure to SSRIs does not affect neurodevelopment, interpretation must be tempered given small sample sizes. The only published study that focused on prenatal SSRI exposure and ASD found an increased risk with exposure to SSRIs, especially during the first trimester. Obstacles that will be faced in future research are isolating medication effects from maternal depression and, given the infrequent occurrence of exposure and outcome, obtaining an adequate sample size. Whether serotonin is an etiologic factor in ASD, and what it points to as a marker for subgrouping, remains unclear. Understanding how the development of ASD might be affected by prenatal factors that influence serotonin levels, such as SSRIs, could identify modifiable targets for prevention.",
keywords = "Autism spectrum disorders, Pregnancy, Selective serotonin reuptake inhibitors, Serotonin",
author = "Harrington, {Rebecca A.} and Lee, {Li Ching} and Crum, {Rosa M.} and Zimmerman, {Andrew W.} and Irva Hertz-Picciotto",
year = "2013",
month = "6",
doi = "10.1002/aur.1288",
language = "English (US)",
volume = "6",
pages = "149--168",
journal = "Autism Research",
issn = "1939-3806",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - Serotonin Hypothesis of Autism

T2 - Implications for Selective Serotonin Reuptake Inhibitor Use during Pregnancy

AU - Harrington, Rebecca A.

AU - Lee, Li Ching

AU - Crum, Rosa M.

AU - Zimmerman, Andrew W.

AU - Hertz-Picciotto, Irva

PY - 2013/6

Y1 - 2013/6

N2 - Serotonin, a neurotransmitter found throughout the brain and body, has long been of interest in autism. Repeated findings of elevated platelet serotonin levels in approximately one third of children with autism has led some to believe that dysfunctional serotonin signaling may be a causal mechanism for the disorder. Because serotonin is critical to fetal brain development, concerns have arisen regarding prenatal exposure to substances that manipulate serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs). This review examines evidence regarding the serotonin system and autism spectrum disorders (ASD), as well as what the literature has reported thus far on developmental effects of prenatal exposure to SSRIs. Possible mechanisms by which SSRIs could affect the fetus during pregnancy and clinical implications are also discussed. Though the majority of studies conducted in infants and children suggest prenatal exposure to SSRIs does not affect neurodevelopment, interpretation must be tempered given small sample sizes. The only published study that focused on prenatal SSRI exposure and ASD found an increased risk with exposure to SSRIs, especially during the first trimester. Obstacles that will be faced in future research are isolating medication effects from maternal depression and, given the infrequent occurrence of exposure and outcome, obtaining an adequate sample size. Whether serotonin is an etiologic factor in ASD, and what it points to as a marker for subgrouping, remains unclear. Understanding how the development of ASD might be affected by prenatal factors that influence serotonin levels, such as SSRIs, could identify modifiable targets for prevention.

AB - Serotonin, a neurotransmitter found throughout the brain and body, has long been of interest in autism. Repeated findings of elevated platelet serotonin levels in approximately one third of children with autism has led some to believe that dysfunctional serotonin signaling may be a causal mechanism for the disorder. Because serotonin is critical to fetal brain development, concerns have arisen regarding prenatal exposure to substances that manipulate serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs). This review examines evidence regarding the serotonin system and autism spectrum disorders (ASD), as well as what the literature has reported thus far on developmental effects of prenatal exposure to SSRIs. Possible mechanisms by which SSRIs could affect the fetus during pregnancy and clinical implications are also discussed. Though the majority of studies conducted in infants and children suggest prenatal exposure to SSRIs does not affect neurodevelopment, interpretation must be tempered given small sample sizes. The only published study that focused on prenatal SSRI exposure and ASD found an increased risk with exposure to SSRIs, especially during the first trimester. Obstacles that will be faced in future research are isolating medication effects from maternal depression and, given the infrequent occurrence of exposure and outcome, obtaining an adequate sample size. Whether serotonin is an etiologic factor in ASD, and what it points to as a marker for subgrouping, remains unclear. Understanding how the development of ASD might be affected by prenatal factors that influence serotonin levels, such as SSRIs, could identify modifiable targets for prevention.

KW - Autism spectrum disorders

KW - Pregnancy

KW - Selective serotonin reuptake inhibitors

KW - Serotonin

UR - http://www.scopus.com/inward/record.url?scp=84879217408&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879217408&partnerID=8YFLogxK

U2 - 10.1002/aur.1288

DO - 10.1002/aur.1288

M3 - Article

VL - 6

SP - 149

EP - 168

JO - Autism Research

JF - Autism Research

SN - 1939-3806

IS - 3

ER -