Notes

15 Inspiring Facts About ADHD Medication And Pregnancy That You Never Knew
ADHD Medication and Pregnancy

Physicians often struggle to counsel patients about the safety of their ADHD medications during pregnancy. In the meantime, until more research is available, physicians must weigh the benefits of taking medication during pregnancy against the possible risks for offspring in each unique circumstance.

A study that was based on a population-based approach has followed 898 babies who were born to mothers who took ADHD medications during pregnancy (stimulants amphetamine methylphenidate ; dexamphetamine non-stimulants modafinil atomoxetine clonidine) until they were identified as having a developmental disorder, died, or left the country.

Risk/Benefit Discussion

CAP Smart Take

Doctors are concerned with the long-term effects that drug exposure in utero may be a source of harm, particularly for centrally stimulating medications like those used to treat ADHD. It is therefore critical that women receive proper advice from their doctors about the risk/benefit of using medication prior to conception and during pregnancy. In this CAP Smart Take, we examine the latest data in this area and how it could guide the clinical practice.

Previous animal studies and studies on illicit drug use suggest that stimulant drugs are passed to the fetus via the placenta and can adversely affect the development of the fetus and growth. There aren't many studies on the effects of prescription stimulant drugs during pregnancy. Most of the evidence comes from studies conducted in case-control with one arm, which isn't powerful enough to detect any significant connections.

The most recent study by Cohen and colleagues stands out from the others, as it is the largest and most tightly controlled. The study comprised a representative sample of 364,012 births from the Danish Medical Registry, and data on the use of medication was gathered through the analysis of redeemed prescriptions. The researchers specifically excluded women who reported taking SSRI drugs or clonidine because these medications can interact with the fetal NMDA receptor and increase the risk of neurodevelopmental disorders like autism and ADHD. adhd medication list Iam Psychiatry adjusted their analyses in order to account for the timing of exposure and to make sure that they control for confounding factors.

The results of this study as well as other small-scale trials suggest that the majority of women who continue to take their stimulant medication prescribed for ADHD during pregnancy are not experiencing adverse effects on their foetuses. Therefore, it is likely that many pregnant women will continue to use their ADHD medication. It is crucial for doctors to carefully weigh the risks and benefits of these medications prior to giving their pregnant patients the advice to stop taking these medications. No matter what decision they make, it is crucial that pregnant women with ADHD educate their spouses or their partners, extended family members and employers about the decision they have made. This is because the symptoms of inattention, hyperactivity, and impulsivity could be recurred once the mother stops taking her medications.

Pregnancy Tests

Preconception counseling for women with ADHD who want to become pregnant should focus on a comprehensive plan of management that includes both pharmacologic and behavioral treatments and ongoing monitoring throughout the postnatal period. The plan should include a discussion about the current treatment regimens, specifically during the first trimester when the risk of harming the baby due to untreated ADHD are highest. This should be a collaborative effort between primary care and psychiatry, as well as obstetrics.


The discussion on risk and benefits should discuss how a woman intends to manage her symptoms of ADHD during pregnancy, including the impact on family functioning and how she feels about a decision to stop psychostimulant therapy during the initial stages of the pregnancy. This should be based on a thorough review of evidence available, including consideration of the individual patient's needs and concerns.

In a recent study that followed children exposed to ADHD medications in utero The authors concluded that "continuation of psychostimulant use during the early stages of pregnancy didn't increase the risk of adverse birth outcomes, and, if anything, was associated with decreased stress on the mother." However this conclusion isn't without its limitations. The study did not take into account other aspects, including the duration of time stimulant medication was taken, the dose and the sociodemographics. There is also no research controlled that studies the safety of a continued use of psychostimulants by nursing mothers.

There is no clear evidence from a scientific study on the safety of ADHD medication during pregnancy. However, most doctors are aware of what research suggests and apply best practices when assessing each patient's individual needs. For instance, it's well-known that there is a higher risk of cardiac malformations in babies born to mothers who take methylphenidate within the first trimester of pregnancy (Cooper and colleagues., 2018) However, it is important to note that this result was based on one small study that did not take into account differences in patient demographics or the underlying psychiatric co-morbidity.

In an earlier survey of ADDitude readers, they found that they are more likely than ever to stop taking their ADHD medication during early pregnancy. Women who stopped taking psychostimulants in the first trimester noticed an increase in depression symptoms. They also felt less able to enjoy pregnancy and rated family functioning as more challenging than those who remained on their dose of ADHD medication or increased it.

Work Functioning Test

The test for work function is an essential element of the test as it will determine if the patient is able to perform their duties. The test is designed to assess functional limitations and include the use of graded material handling (lifting to different levels, pushing and pulling), positional tolerance activities (sitting, standing and walking, balancing and stooping, kneeling and crawling) as well as other relevant tests for specialized testing (hand manipulation). The examiner will analyse the results and draw a return to work conclusion. ROC curves are used to determine the point of minimum misclassification (MIC) for both physical and general working ability as well as the functional problem score.

The MIC is calculated based on the COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. This method is able to separate the scores of physical and general ability and work-functioning problems score by answer on an anchor question to prevent changes in the measurement from affecting the overall average.

Driving Test

Psychostimulant medication is a gold treatment for ADHD. It improves safety while driving and reduces symptoms. If not treated, severe ADHD can have serious financial and psychological consequences.

Psychotherapeutic treatments, like cognitive behavior therapy (CBT) or "coaching" methods have also been shown by research to reduce symptoms and improve performance. These strategies can help women tailor their schedules and utilize their coping skills in ways that minimize the impact of ADHD on their work and other areas.

All of these factors are important to consider when deciding whether or not to continue with psychostimulant therapy. The most reliable data available show that although there are some concerns regarding the outcome of pregnancy when in utero stimulant medication is used, the relative risks of this are low. Additionally, the results are muddled by other medication, the use of maternal healthcare and physical and mental health, and other comorbidities. Bang Madsen K., Bliddal m., Skoglund cb., Larsson h., Munk-Olsen T., Hove Thomsen p., Bergink V. In-utero exposure of attention-deficit/hyperactivity disorder medication and its effects on offspring.

Read More: https://www.iampsychiatry.com/adult-adhd-medication