Antidepressants and Autism Ranking:

Risks and Safety

Hazards

According to Mind (2016), there are some side effects that are common to all antidepressants of a particular type.

“Side effects that all drugs of this type can cause (most common first)

“SSRIs and SNRIs      

• decreased alertness
• sexual problems
• diabetes
• SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
• serotonin syndrome
• suicidal feelings
• neuroleptic malignant syndrome
• hypomania or mania

“Tricyclic and tricyclic-related antidepressants

• antimuscarinic effects
• tooth decay
• decreased alertness
• suicidal feelings
• serotonin syndrome
• SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
• diabetes
• neuroleptic malignant syndrome
• hypomania or mania

MAOIs           

• decreased alertness
• SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
• serotonin syndrome
• diabetes
• suicidal feelings
• neuroleptic malignant syndrome

Autism

There is some evidence that some specific antidepressants may be potentially harmful to autistic people. For example, according to NICE (2013),

“There was single study evidence for statistically significant harms associated with the antidepressant citalopram, including: increased energy level; disinhibited, impulsive or intrusive behaviour; decreased attention and concentration; hyperactivity; stereotypy; diarrhoea; any insomnia and initial insomnia or difficulty falling asleep; skin or subcutaneous tissue disorder.”

Contraindications

Some antidepressants may be contraindicated (something which makes a particular treatment or procedure potentially inadvisable) in certain groups of people or under certain circumstances.  For example, according to NHS Choices (2015)

• Antidepressants can react unpredictably with other medications, including over-the-counter medications such as ibuprofen
• You should never take two different types of antidepressants, such as an SSRI and a TCA, unless advised by the doctor in charge of your care. This is because taking certain combinations of antidepressants can make you feel very ill and can be life-threatening
• As a precaution, antidepressants aren't usually recommended for most pregnant women, especially during the early stages of a pregnancy.
• As a precaution, the use of antidepressants if you're breastfeeding isn't usually recommended.
• The use of antidepressants isn't usually recommended in children and young people under the age of 18. This is because there's evidence that, in rare cases, they can trigger thoughts about suicide and acts of self-harm in this age group.
• You should be wary of drinking alcohol if you're taking antidepressants, as alcohol is itself a depressant and drinking alcohol can make your symptoms worse.
• The use of illegal drugs isn't recommended if you're taking antidepressants, particularly if you've been prescribed a TCA. This is because they can cause unpredictable and unpleasant effects
• Taking St John's Wort with other medications, such as ... antidepressants ..., can also cause serious health problems.
• Some antidepressants can cause dizziness, drowsiness and blurred vision, particularly when you first start taking them. If you do experience these problems, you should avoid driving or using tools and machinery.

According to the Royal College of Psychiatrists (2015), there are also some specific contraindications for certain types of antidepressants. For example,

• SSRIs: There is some evidence of increased suicidal thoughts (although not actual suicidal acts) and other side-effects in young people taking SSRIs.
• SNRIs: Venlafaxine should not be used if you have a serious heart problem. It can also increase blood pressure, so this may need to be monitored.
• Tricyclics: Tricyclics may cause confusion, slowness in starting and stopping when passing water, faintness through low blood pressure, and falls – especially in older people.  If you have heart trouble, it may be best not to take one of this group of antidepressants.
• MAOIs. MAOIs can give you a dangerously high blood pressure if you eat foods containing a substance called tyramine. If you agree to take an MAOI antidepressant your doctor will give you a list of foods to avoid.

Explanation of terms

Antimuscarinic (type of drug used to treat gastrointestinal problems); diabetes (condition caused by excessive glucose); hypomania or mania (over active and excited behaviour); neuroleptic malignant syndrome (life threatening condition resulting from use of some drugs); Serotonin syndrome (symptoms resulting from use of drugs which change levels of serotonin); Syndrome of Inappropriate Antidiuretic Hormone Secretion (unnecessary production of the antidiuretic hormone); tyramine (natural compound found in some foods).

More information

There are numerous publications and websites which provide more details on the potential hazards and contraindications for antidepressants including Mind (2016); NHS Choices (2015), Royal College of Psychiatrists (2015).

Updated

17 Jun 2022

Last Review

01 Jan 2017

Next Review

01 Jul 2023