ADHD Medication During Pregnancy
Pregnancy can be a challenging time for women with ADHD. Women with ADHD are often faced with the decision of whether to continue taking their ADHD medication during pregnancy.
The good news is that new research has shown that it is safe for pregnant women to continue taking their medications. This study, which is the largest of its kind, compares babies exposed to stimulant medications (methylphenidate amphetamine, dexamphetamine and lisdexamphet) and non-stimulants (modafinil, atomoxetine, and clonidine). The results show that exposure to stimulants was not associated with malformations in the offspring.
Risk/Benefit Discussion
Women who suffer from ADHD planning to have a baby must weigh the benefits and risks of a treatment regimen against their unborn child. This discussion is best done before a woman is pregnant, but this is not always possible.
The risk of adverse gestational outcomes for the fetus associated with psychostimulant exposure is small. However, recent sensitivity analyses that take into account important confounding factors have indicated an increased risk of adverse gestational outcomes for amphetamine and methylphenidate products.
Women who are uncertain about their plans for pregnancy or already taking ADHD medications should consider an unmedicated trial prior to becoming pregnant. During this time, they should consult with their doctor to create a plan for how they can manage symptoms without medication. This may include making accommodations at work or in their daily routine.
First Trimester Medications
The first trimester is an important time for the fetus. The fetus grows its brain and other organs in this stage which makes it more vulnerable to environmental exposures.
Previous studies have demonstrated that taking ADHD medication in the first trimester doesn't increase the chance of adverse outcomes. These studies used much smaller samples. The sources of data, the types of medications studied, definitions of pregnancy and offspring outcomes, and the types of control groups were also different.
In a large-scale cohort study, the authors observed 898 women who were exposed to ADHD medications (stimulants: methylphenidate and amphetamine modafinil; non-stimulants: atomoxetine and atomoxetine) throughout their pregnancy. They compared women exposed to the medication to those who were not. The researchers found no evidence of an increased risk for fetal malformations, such as heart and central nervous system.
Second Trimester Medications
Pregnant women who continued to take ADHD medication during the second trimester were at a higher rate of complications including the need for caesarean deliveries and babies with low Apgar scores. They also had an increased risk for pre-eclampsia, urine protein and swelling.
Researchers used a nationwide registry to track pregnancies that were exposed to prescriptions redeemed for ADHD medications, and then compared them with pregnancies that did not have prescriptions redeemed. They assessed for major malformations (including those of the heart and central nervous system) and other outcomes, including miscarriage, termination, stillbirth and the death of a perinatal baby.
These findings should give peace of mind for women with ADHD who may be considering the idea of having a child and their medical professionals. This study was limited to stimulant medications, and more research is needed. Cognitive-behavioral treatment can help manage ADHD symptoms and is generally safe during pregnancy.
Medicines during the Third Trimester
Despite the fact that women who take stimulant medication for ADHD frequently decide to continue their treatment when pregnant, no systematic study of this topic has been undertaken. The few studies that have been carried out suggest that pregnancy-related and offspring outcomes are generally unaffected by exposure to in utero prescribed ADHD medications (Kittel-Schneider 2022).
However, it is important to be aware that the minor risk differences that are associated with intrauterine exposure to medications could be altered by confounding variables, such as prenatal psychiatric history and general medical conditions and chronic comorbid medical conditions and age at conception and maternal comorbidity. A study has not yet been conducted to determine the long-term effects of ADHD medication in utero on offspring. Future research is needed in this field.
The fourth trimester is the time for medication
Many factors influence a woman's decision to continue or stop taking ADHD medication during pregnancy and postpartum. It is advisable to discuss your options with your healthcare professional.
Studies to date have exhibited small associations between ADHD medication use during pregnancy and adverse birth outcomes, however because of the small sample size and the lack of control over confounding factors, these results must be taken with caution. Additionally studies have not evaluated the relationship between ADHD medication and long-term outcomes for offspring.
In several studies, it was found that women who continued using stimulant medications to treat their ADHD during pregnancy or after the birth of a child (continuers) showed different sociodemographic and medical characteristics than women who stopped taking their medication. Future research should assess whether certain periods of time during pregnancy are more sensitive to the effects of stimulant medication exposure.
The Fifth Trimester
Based on the severity of symptoms and the presence of any other co-occurring disorders, some women with ADHD decide to stop taking medication prior to pregnancy or when they find out they are expecting. Many women, however, notice that they have difficulty functioning at work or with their families when they stop taking their medication.
This is the most comprehensive study to date to examine the impact of ADHD medications on the fetal outcome and pregnancy. It differed from previous studies in that it did not limit the data to live births only however, it also included instances of teratogenic adverse effects that were severe that resulted in abrupt or forced terminations of pregnancy.
The results provide reassurance for women who rely on their medications and need to continue treatment during pregnancy. It is important to talk about all options available for managing symptoms including non-medication options like EndeavorOTC.
The Sixth Trimester
The literature available suggests, in summary, that there isn't any definitive evidence to suggest that ADHD medication can cause teratogenic effects during pregnancy. However, due to the lack of research on this topic further studies utilizing various studies to examine the effects of specific medication exposures and a more thorough assessment of confounding effects and long-term outcomes in offspring are required.
GPs can inform women with ADHD that they should continue to receive treatment throughout the pregnancy, especially when it is associated with greater performance at work and at home, decreased symptoms and comorbidities or increased safety when driving and doing other activities. There are also effective non-medication alternatives for ADHD, such as cognitive behavioral therapy or EndeavorOTC.
These treatments are safe and they can be included in an overall treatment program for those suffering from ADHD. If you decide to quit taking your medication, you should try a trial of few weeks is recommended to evaluate functioning and determine whether the benefits outweigh any risks.
Medicines during the seventh trimester
ADHD symptoms interfere with women's ability to work and maintain her home, so many women choose to take their medications during pregnancy. There isn't much research about the safety issues associated with the use of psychotropic medications during perinatal time.
Studies of women who are prescribed stimulants during pregnancy have shown an increased risk of adverse pregnancy-related outcomes and a higher likelihood of admission to the neonatal intensive care unit (NICU) after birth compared with women who are not treated.
A new study compared 898 children born to mothers who took stimulant medication for ADHD during pregnancy (methylphenidate amphetamine, dexamphetamine, and lisdexamphe) against 930 children from families who did not take ADHD medications. Researchers tracked the children until they reached age 20, left the country or died, whichever came first. Researchers compared the children’s IQ academic performance, academic performance, and behavior to their mothers’ history of ADHD medication usage.
Eighth Trimester Medications
If the symptoms of ADHD cause significant impairments in a woman's work and family functioning, she could decide to take the medication during pregnancy. Recent research has shown that this is safe for a fetus.
Women with ADHD who are taking stimulant medication in the first trimester are at the highest risk of having a caesarean delivery, and a greater chance that their infants will be admitted to the neonatal Intensive Care Unit. These increases were observed even after taking into consideration the mothers' pre-pregnancy history.
However, adhd no medication is needed to understand why these effects took place. In addition to RCTs, more observational studies that consider the timing of exposure as well as other factors that cause confusion are needed. This could help determine the true potential teratogenicity of taking ADHD medication during pregnancy.
Medications in the Ninth Trimester
The medication for ADHD can be taken throughout pregnancy to help combat the debilitating symptoms caused by ADHD and to assist women in functioning normally. These findings are comforting for patients who are planning to become pregnant, or are expecting.
The authors compared the infants of mothers who continued to take stimulant drugs throughout pregnancy with babies born to mothers who had cut off their use. The researchers controlled for a number of factors including maternal and pregnancy characteristics, chronic conditions, indications for the medications (stimulants: amphetamine/dextroamphetamine, methylphenidate), health care utilization intensity and cotreatment with psychiatric or pain medications.
The study did reveal that women who continued to take stimulant medications during the ninth trimester were at risk of a slight increased risk of spontaneous abortion and a low Apgar score at birth and admission to the neonatal intensive care unit. The risks were minimal, and they did not increase the risk of adverse outcomes in the mother or the child.