TriDereka Hall

February 14, 2017

Psychology of Child Development
Homework #2
According to the textbook, a teratogen is an agent that causes abnormal prenatal
development. (Kail, 2015) Teratogens such as alcohol, cocaine, marijuana, smoking, etc, can
cause various abnormalities. These teratogens can cause major damages to the fetus and possibly
cause the child to be born with effects such as malformations, cognitive disabilities, or damage to
the central nervous system. Specifically, antidepressants are also classified as a teratogen. There
has been a lot of controversial research on the use of antidepressants for pregnant women.
Pregnant women who suffer with major depression and took tricyclic antidepressant drugs and
agents had selectively inhibited the reuptake of serotonin, which is critical in the development of
the fetus. (Byatt, 2013)
The teratogenic effects of antidepressants appear to cause many different effects based on
the type of antidepressant the mother ingests, the amount, and the timing of exposure. The
chemical structures are different in many antidepressants, according to Iqbal (1999). He believed
that no chemical combinations had any advantage over another one. The structures also resulted
in there being a lot of variability in the effects based on the amounts of doses. For example, the
antidepressant, protriptyline, did not have any effects on animals that had the drug even though it
was 10 times the recommended amount versus the antidepressant, trimipramine, that caused
major anomalies when ingested over 20 times the amount recommended. On each of the
websites I found, it did not give a specific amount but said the amount recommended or high
doses. There were not specifications. Nulman indicated that the teratogenic effects can become
apparent at the critical point for malformations caused by drugs (2-8 weeks) but, because the
brain is constantly developing it can occur after that period. The effects of antidepressants can
show up during birth or after through the child during lactation. The effects can be postnatal
during lactation or by the mother having postpartum depression resulting in the child having a
developmental delay, impaired language development, and lower IQ scores. (Byatt, 2013) The
articles also did not give concrete information on if the effects changed based upon the postnatal
environment. It was mainly concentrated on the progression antenatal.

There were effects in both animals and humans according to the study by Iqbal (1999).
He included an extensive chart that had the effects of both of them as it pertains to different
chemical structures of antidepressant drugs. In the chart, he gave the comparison of the effects
on animals versus humans. A few of the chemical structures he mentions are imipramine,
desipramine, and amitriptyline. He concluded for imipramine, the effect for animals were reports
of congenital malformations and for humans, controlled studies had not been done, but there had
also been reports of congenital malformations such as cleft palate, spina bifida, cardiovascular
effects, etc. For desipramine, the animal studies were inconclusive and for humans, there were no
reports of congenital malformations, but there were reports of neonatal withdrawal symptoms.
For amitriptyline, animals were reported to show teratogenic effects when taken in high doses
and humans in the study also had studies were not well-controlled but there were reports of limb
reduction anomalies or developmental delays from this specific chemical structure.

The research in each of the studies by Iqbal and Nulman had flaws and the articles were
limited because there has not been a lot of concrete research on the topic of the effects of
antidepressant use on the fetus. The research itself is not well-controlled as it pertains to the
participants and it has the limitation of inconsistent findings between studies. Some research has
information that says the use of the antidepressant drugs can be more beneficial than for the
mother to be in a depressed state. However, I believe that the information on the websites I found
were pretty consistent with the fact that they believe the research is not well-developed. I looked
at the information in separate years apart and they still have some of the same conclusions.

The information in the research I read relates to the textbook when it explains how
teratogens can affect organisms differently. In the study by Iqbal, it was reported that animals
that had taken doxepine had no teratogenic effect but could result in neonatal death. (1999) In
contrast, humans did have teratogenic effects that resulted in oral cleft or polydactyly. Also, the
textbook explains that teratogens affect a specific aspect of prenatal develop. The consequences
of ingesting antidepressant drugs are really varied dependent upon the specific chemical
structure, so one is not guaranteed to get the same effect from each one. One type of
antidepressant can result in congenital malformation from ingesting one type versus having
cognitive developmental delays from another type.

Based on the information in the textbook, I would recommend that pregnant women
avoid any teratogenic aspects that they can control. A woman can control not taking certain
drugs such as cocaine and alcohol, but it would be harder to try to control for environmental
hazards such as air pollutants. And its also more difficult for women is poverty to avoid certain
teratogens as well. For my particular teratogen, antidepressants, Im not exactly sure what I
would suggest to a pregnant who is suffering from depression. I agree that the research is
controversial, making it harder to form an opinion. A depressed woman can suffer from either
untreated depression, postpartum depression or taking antidepressants so it is just determining
which effects are worse.

For this assignment, I visited 4 different websites. The first one was the University of
North Texas school site and the article was titled The Pros and Cons of Antidepressant Use on
Pregnancy. I would give this site a quality rating of a 3, because it provided good information
for me to be able to research other aspects of my topic. It was just a base. I would have liked it to
be more like a research study to give me more sources, but the website itself was published by
the university, so I feel like its still reliable. The second site was a research study from the New
England Journal of Medicine, titled Neurodevelopment of Children Exposed in Utero to
Antidepressant Drugs. I would give this site a quality rating of a 4, because it gave me really
good information about my topic from different research studies that have been done before and
compressed it together. I believe this source is reliable because it is from a reviewed journal. The
third website was a research from the Annals of Clinical Psychology, titled Effects of
Antidepressants During Pregnancy and Lactation. I would give this website a quality rating of a
4 as well, because I received a lot of data from the charts it provided, but at the same time the
information was dated. The last was a research study on the US National Library of Medicine
National Institutes of Health website, titled Antidepressant Use in Pregnancy: A Critical
Review Focused on Risks and Controversies. I would give this website a quality rating of a 4,
because it goes into the controversy that my topic faces for me to better understand why the use
of antidepressants for pregnant women cannot be concrete.

Works Cited

Byatt, N., Deligiannidis, K. M., & Freeman, M. P. (2013). Antidepressant Use in Pregnancy: A

Critical Review Focused on Risks and Controversies. Acta Psychiatrica Scandinavica,

127(2), 94114. http://doi.org/10.1111/acps.12042

Iqbal, M. M. (1999). Effects of Antidepressants During Pregnancy and Lactation. Annals Of

Clinical Psychiatry, 11(4), 237-256. doi:10.1023/A:1022317630703
Kail, R. V. (2015). Children and their development(Seventh Edition). Boston: Pear.
Nulman, I., Rovet, J., Stewart, D. E., Wolpin, J., Gardner, H. A., Theis, J. G., ... & Koren, G.
(1997). Neurodevelopment of children exposed in utero to antidepressant drugs. New
England Journal of Medicine, 336(4), 258-262.
The Pros and Cons of Antidepressant Use During Pregnancy. (2012, March 6). Retrieved
February 14, 2017, from
http://ttis.unt.edu/news/pros-and-cons-antidepressant-use-during-pregnancy