Common Medications May Disrupt Brain Development

New research links psychiatric and heart drugs to potential health risks.

Taras Grebinets/Shutterstock

Many people don’t think twice when their physician prescribes antidepressants or other medications. However, new research suggests that some of these drugs may quietly interfere with brain development in unborn children, raising urgent safety concerns during pregnancy.

A February review authored by University of Nebraska Medical Center researchers and published in Brain Medicine suggested that more than 30 widely used drugs—including some antipsychotics, antidepressants, and heart medications—may interfere with cholesterol production in the brain, a process essential for cognitive function and neural growth.

The researchers analyzed how these medications disrupt sterol biosynthesis, particularly affecting the DHCR7 enzyme, which helps regulate cholesterol levels. Their findings highlight potential risks and raise concerns about drug safety, especially during pregnancy and early childhood, when brain cholesterol synthesis is crucial for development.

Brain Development

Cholesterol is essential for brain development and function. It helps build cell membranes, protects nerve fibers with myelin, and supports connections between neurons. Cholesterol also plays a key role in neuron growth, movement, and communication.

Once the blood-brain barrier forms during early development, cholesterol from the body can’t enter the brain. As a result, the brain must produce its own cholesterol.

The blood-brain barrier is a protective filter that controls what enters the brain from the bloodstream, keeping harmful substances out while allowing essential nutrients in.

“Disrupting cholesterol biosynthesis, particularly during early development, can have profound consequences, including impaired neuronal connectivity, reduced myelination, and altered neurotransmitter function,” Dustin Hines, a neuroscientist, researcher, and psychology professor at the University of Nevada–Las Vegas, who was not involved in the study, said in an email to The Epoch Times.

“These disruptions may lead to deficits in cognition, sensory processing, and motor coordination,” he said.

Cholesterol also plays an important role in making steroid hormones and bile acids essential for various body functions.

Maintaining balanced cholesterol levels is important for brain health during development and adulthood. The review highlights findings from previous studies showing that higher brain cholesterol is linked to better memory in aging, while lower levels may increase the risk of depression, as well as aggression, impulsivity, and violence.

Moreover, disruptions in cholesterol production or metabolism have been observed in neurodegenerative diseases such as Alzheimer’s and Huntington’s.

Drug Culprits

The review indicates that some widely prescribed medications cross the blood-brain barrier, raising concerns about long-term effects on brain health. Pregnant women and unborn babies are especially at risk because the brain needs cholesterol to develop properly during pregnancy and early childhood.

Some of the medications include:

• Cariprazine—used for mental health conditions
• Trazodone—antidepressant
• Aripiprazole—antipsychotic
• Haloperidol—antipsychotic
• Sertraline—antidepressant
• Metoprolol—heart medication

Lead study author Dr. Karoly Mirnics, a professor of psychiatry, biochemistry, and molecular biology at the University of Nebraska Medical Center, emphasized how widely these medications are used.

“Approved medications that can interfere with normal sterol biosynthesis during development belong to various classes. These medications are commonly used for cardiology and hypertension treatment, some of which are routinely prescribed to pregnant women,” he told The Epoch Times in an email.

Examples of such drugs include statins and ACE inhibitors, which are used to treat high cholesterol and hypertension.

Sterols are fat-like molecules essential for making cholesterol in the body. They act as building blocks in the cholesterol production process. Because the brain cannot absorb cholesterol from the blood, it relies on sterol biosynthesis to make its own.

“These medications are generally safe and lifesaving for most people, especially adults. However, during pregnancy, their effects—when combined with certain genetic factors, the use of multiple sterol-inhibiting medications, underlying health conditions, or lifestyle factors—could become harmful to the unborn child,” Mirnics said.

The Biochemical Link

The medications listed above can block the DHCR7 enzyme, preventing the proper conversion of 7-DHC (7-dehydrocholesterol) into cholesterol. This leads to a buildup of 7-DHC, which is highly reactive and forms harmful byproducts called oxysterols, which can damage neurons, disrupt brain function, and potentially increase the risk of neurodevelopmental disorders.

The review suggests that medication-induced sterol disruption may create a biochemical state similar to Smith-Lemli-Opitz syndrome, a genetic condition in which 7-DHC accumulates because of a defective DHCR7 enzyme, leading to developmental and cognitive impairments.

Mirnics’s previous research supports the current study’s findings. His 2023 study, published in Biomolecules, found that aripiprazole and trazodone block the DHCR7 enzyme, disrupting cholesterol production in mice’s brains and other organs.

Researchers treated mice with these drugs for 21 days and found that both accumulated in different tissues, altering sterol metabolism. Female mice also showed higher cholesterol clearance in the brain, suggesting their bodies metabolized and removed aripiprazole more quickly than male mice.

People at Potential Risk

The review also highlights that about 3 percent of the population may be more vulnerable because of genetic differences in sterol processing, and taking multiple medications can further worsen disruption.

That means people with one faulty DHCR7 gene are usually healthy and make up about 1 percent to 3 percent of the population.

“However, when exposed to certain medications, their ability to process sterols is significantly impaired, much like a pulled muscle—fine at rest but struggling under stress,” Mirnics said.

Another study analyzed 1,312 blood samples from pregnant women and found that 302 had high levels of 7-DHC, a cholesterol precursor that can become toxic if not properly processed.

Among these, 43 samples contained medications that block the DHCR7 enzyme, preventing 7-DHC from converting into cholesterol. Moreover, the study notes that taking DHCR7-inhibiting drugs during the first trimester may be harmful to the baby and could increase the risk of birth defects.

“If such medications are essential, it may be beneficial to monitor neurodevelopmental milestones closely, supplement with supportive nutrients, and consider alternative treatments when possible. Parents should also be aware of early warning signs of cognitive or behavioral changes and seek neurodevelopmental assessments if concerns arise,” Hines said.

Implications for Patient Care

Given cholesterol’s essential role in brain development, health care providers should carefully weigh the risks and benefits before prescribing cholesterol-lowering drugs or other sterol-inhibiting medications to pregnant women, infants, and young children.

Parents and patients should have open discussions with health care providers about the need for medications that affect cholesterol metabolism.

While some medications are necessary during pregnancy, selecting one without DHCR7-inhibiting effects may lower the risk of complications and support better health outcomes for the baby.

“During pregnancy, especially if the unborn child or future mother has a potentially vulnerable genotype, I would suggest replacing the medication with one without the unwanted sterol-inhibiting side effect,” Mirnics said.

“Usually there are plenty of good options, and the majority of medications in all different classes do not interfere with sterol biosynthesis.”

While the study suggests that health care providers should assess current and future medications for their potential to affect sterol biosynthesis during development, Mirnics noted the need for larger studies to confirm these findings.

“Animal and cultured cell studies raise concerns, but they are not the same as comprehensive human studies. There is still so much we don’t understand, and we should be cautious about drawing premature conclusions,” he said.

Patients should not stop taking medications without consulting a doctor. Health care providers should consider the potential effects on sterol biosynthesis when prescribing multiple drugs, including those commonly used to treat heart and psychiatric diseases. If these drugs are necessary, genetic testing for both the mother and unborn child could help assess risks and guide treatment decisions.