AD/HD Medications During Pregnancy
Since approximately 3 - 5% of the adult population struggles with symptoms related to AD/HD, including women who are planning on having children, there are frequent questions about use of medications during pregnancy.
Stimulant medications, including methylphenidate (Ritalin, Concerta, Metadate CD, and others), mixed amphetamine salts (Adderall, Adderall XR), and dextroamphetamine (Dexedrine) remain the first-line medication for treatment of AD/HD.
There have been no well-controlled studies of stimulant use during pregnancy (ethically, a study giving a stimulant medications to pregnant women would not be authorized by the FDA). Stimulants are classified as Category C by the FDA (Animal studies show adverse effects, but there are no controlled human studies).
Amphetamines (Adderall and Dexedrine) given to mice in doses much higher than the usual human dose have reported cardiac defects. Studies of women addicted to amphetamines have shown higher rates of low birth rate and pregnancy complications. Another study found that children of women exposed to Dexedrine had a higher incidence of heart defects at three-year follow-up. A study of 48 women exposed to methylphenidate during pregnancy found higher rates of premature birth, growth retardation, and symptoms of withdrawal in the infants.
Modafanil (Provigil) and atomoxetine (Strattera) are also category C drugs, with inadequate information available to assess risk. There is also not enough information about bupropion (Wellbutrin) to assess risk, and although it's a category B drug (preferred over category C drugs), there is some concern about its use during pregnancy and a potential for congenital heart defects.
All medications are excreted into breast milk, exposing them to the infant. Amphetamines are concentrated in breast milk which causes concern about typical side effects of stimulant medications as well as withdrawal symptoms. There is no information about methylphenidate during nursing. There is too little information available about atomoxetine and modafanil to recommend their use during breastfeeding.
More information is needed regarding medications used to treat AD/HD during pregnancy and while nursing. Although the risks versus the benefits of using medications during pregnancy and while nursing should be thoroughly discussed with someone's physician, there is currently no information to indicate that treatment of AD/HD with medication is a safe choice.
Alternatively, I recommend working with an ADD Coach/ Organizer (or experienced therapist) on skills for planning, organization, time management, and follow-through.
Dr. Richard Sogn
Related Topics: Pregnancy Antidepressants: Baby Risk, Dads Get PostPartum Depression, Too
Technorati Tags: AD/HD, pregnancy, stimulant medication
Stimulant medications, including methylphenidate (Ritalin, Concerta, Metadate CD, and others), mixed amphetamine salts (Adderall, Adderall XR), and dextroamphetamine (Dexedrine) remain the first-line medication for treatment of AD/HD.
There have been no well-controlled studies of stimulant use during pregnancy (ethically, a study giving a stimulant medications to pregnant women would not be authorized by the FDA). Stimulants are classified as Category C by the FDA (Animal studies show adverse effects, but there are no controlled human studies).
Amphetamines (Adderall and Dexedrine) given to mice in doses much higher than the usual human dose have reported cardiac defects. Studies of women addicted to amphetamines have shown higher rates of low birth rate and pregnancy complications. Another study found that children of women exposed to Dexedrine had a higher incidence of heart defects at three-year follow-up. A study of 48 women exposed to methylphenidate during pregnancy found higher rates of premature birth, growth retardation, and symptoms of withdrawal in the infants.
Modafanil (Provigil) and atomoxetine (Strattera) are also category C drugs, with inadequate information available to assess risk. There is also not enough information about bupropion (Wellbutrin) to assess risk, and although it's a category B drug (preferred over category C drugs), there is some concern about its use during pregnancy and a potential for congenital heart defects.
All medications are excreted into breast milk, exposing them to the infant. Amphetamines are concentrated in breast milk which causes concern about typical side effects of stimulant medications as well as withdrawal symptoms. There is no information about methylphenidate during nursing. There is too little information available about atomoxetine and modafanil to recommend their use during breastfeeding.
More information is needed regarding medications used to treat AD/HD during pregnancy and while nursing. Although the risks versus the benefits of using medications during pregnancy and while nursing should be thoroughly discussed with someone's physician, there is currently no information to indicate that treatment of AD/HD with medication is a safe choice.
Alternatively, I recommend working with an ADD Coach/ Organizer (or experienced therapist) on skills for planning, organization, time management, and follow-through.
Dr. Richard Sogn
Related Topics: Pregnancy Antidepressants: Baby Risk, Dads Get PostPartum Depression, Too
Technorati Tags: AD/HD, pregnancy, stimulant medication
8 Comments:
I am an attorney recently diagnosed with AD/HD, and several other mental health conditions that severely impact my work.
I am under a doctor's care, but he is not experienced with suggesting reasonable accommodations for people in my profession.
My employer has agreed to provide me with accommodations, but I'm not really sure what exactly to seek. A reduction in workload, more time on certain assignments, teaming up with another attorney? I was hoping someone could share some specifics.
Thanks,
Trying to pay attention in Oakland.
Anthony:
I have also been DX w/ adult ADD. My initial response was one of relief, but this was soon eclipsed by the infinite nature of the question, "what now?" The most valuable resources for realistic life-management skills that I have encountered (at the advice of my incredible doctor) are John Ratey and Ed Hallowell's books "Delivered From Distraction," and "Driven to Distraction." The latter focuses more on adult ADD, which is refreshing. I've heard that Dr. Ratey has an even newer book called "A User's Guide to the Brain." I hope this is helpful and wish you the best of luck.
I have been on medication for ADHD, for over 12 years. Now I am pregnant and was told to not take the medicine. I am starting a new job and can already tell that I am going to fall off the deep end because I am unable to take my meds. Does anyone know of woman who have taken ADHD drugs while pregnant and not experienced problems with delivery and child. Thanks, advise is really needed right now.
i am 5 months pregnant and have severe anxiety and add. I have always taken adderall and xanax but now that i am pregnant they swithed me to clonazepam and lowered my dose of adderall, they say it can cause low birth weight if taken in high doses.
I'm a 22 years old army wife and mother of 1 and expecting another recently diagnosed with adhd... Or so i've been told... see I think i'm in denial. ALl my life my school problems were laziness and lack of motivation on my own part, no disease and my mom still thinks it's a misdiagnosis. I don't know how to explain to her that it's real if I myself don't believe it. How is it my whole life I was a screw up and now it's not my fault???
i am 13 weeks prenant with my second child, the first prgnancy i stoped taking my ritlin but stayed on my welbutrin for depression, even so my whole life still feel apart with out my normal meds i was used to. this time they are trying to tell me to go off the ritlin again but i havent, i cant afford for my life to fall apart when i have another child to take care of. what i dont understand is welbutrin and ritlin are both class C drugs, but you can take welbutrin duriing pregnancy only because they have done more studies on it and have had no proof of birth defects in humans only animals. same with ritlin though, they just havent done as many studies with the ritlin. so they left the choice up to me but advised me to not take it.
To JeiMtz:
ADHD is usually mistaken for laziness since many time people who suffer from it are able to concentrate at things they like and are interesting to them. I would suggest you do your research and try meds. You could be pleasantly surprised
To JeiMtz:
I am too a military wife and have two children of my own. I also take adderall. As a child I was always told "you have so much potential" Now that my oldest daughter is 6 and in the first grade. she too has ADD/ADHD. Although I have never taken this medication while preg. I found that as a military wife your "life" is much diff than others. I have noticed that taking adderall helped me focus and concentrate on "one thing at a time" which is hard with 2 kids and a hubby that is on his fourth deployment. If you need someone to talk to or whatever please don't hesitate to e mail me pretty_poison1981@yahoo.com
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