Can You Take ADHD Medication During Pregnancy? Understanding the Risks, Benefits, and Making the Best Choice for You

Is it safe to take ADHD medication during pregnancy? Many of my clients face this question when planning a family or finding out they're pregnant. You'll be surprised to learn that many women choose to stay on their medication.

As someone with ADHD, you might wonder what's best for you. It's completely normal to have this concern—it's a sign that you care about your baby's well-being.

To help you navigate this decision, let’s explore what the research says, what top experts like Dr. Allison S. Baker from Massachusetts General Hospital (MGH) advise, and how you can make the choice that’s best for you.

What Does the Research Say About ADHD Medications During Pregnancy?

Life is hard and it can get even harder for pregnant adhd women. When that happens it can cause stress and difficuclty that harms you and your baby. This is why many want to stay on their  medication during pregnancy.

This decision is about balancing what's best for your baby's health with your own mental and physical well-being.

Here’s what the current research shows:

• Stimulant Medications (e.g., methylphenidate, amphetamines): Large studies generally find no increased risk for major congenital malformations, perinatal death, or obstetric complications when using stimulant medications during pregnancy (Baker & Freeman, 2018). However, newer studies suggest a potential, though low, risk of cardiac malformations (such as ventral septal defects, a hole in the heart) associated with methylphenidate use. If you choose to continue this medication, a fetal echocardiogram might be recommended to monitor your baby’s heart development.
• Non-Stimulant Medications (e.g., atomoxetine): The data on non-stimulants is limited. Some studies show no significant risk of major congenital malformations, but due to smaller sample sizes, there is less certainty about potential risks, especially concerning cardiac and limb malformations (Bröms et al., 2023).

Why Some Women Choose to Continue Their Medication

Many women find that managing ADHD symptoms is crucial for maintaining daily function and mental health, especially during pregnancy. Here are some reasons why you might consider continuing your medication:

• Improved Functioning: ADHD medications help you manage the stress you experience because it can help you meet the demands of the world better. These  can be particularly challenging during the physically and emotionally demanding months of pregnancy.
• Preventing Unhealthy Behaviors: Medication might help reduce the For some women, ADHD medications can enhance focus and help maintain routines, making it easier to follow a balanced diet, attend regular prenatal check-ups, and stay engaged in self-care practices that support both mother and baby’s health. (Kittel-Schneider et al., 2021).
• Mental Health Stability: For some women, stopping ADHD medication during pregnancy can lead to a significant increase in anxiety, depression, or other psychiatric symptoms, which can also negatively impact pregnancy outcomes.

Why Some Women Choose to Stop Their Medication

On the other hand, some women opt to discontinue their ADHD medication during pregnancy due to concerns about potential risks to their baby. Here are some reasons why you might choose to stop:

• Concerns About Fetal Development: Even though most research is reassuring, there remains a small, potential risk of birth defects or other complications that some women may prefer to avoid altogether.
• Preference for Non-Pharmacological Treatments: Some women prefer to explore non-pharmacological options for managing ADHD during pregnancy, such as cognitive-behavioral therapy (CBT), mindfulness, lifestyle changes, and support groups.
• Desire to Minimize Medication Use: To reduce any potential unknown risks, some women choose to limit medication use during pregnancy (Scoten et al., 2024).

How to Make the Decision: A Collaborative Approach

Deciding whether to continue ADHD medication during pregnancy is not a decision you need to make alone. A collaborative approach with your healthcare provider can help you.

Here’s how to go about it step by step:

• Discuss Your Options:

Have an open conversation with your healthcare provider about the potential risks and benefits of continuing or discontinuing your medication. Consider factors such as the severity of your ADHD symptoms, your personal medical history, and your comfort level with potential risks.

• Consider a Second Opinion:

Sometimes, it helps to get a second opinion from another healthcare provider, especially one with experience in perinatal psychiatry or ADHD treatment.

• Involve Your Support Network:

Talk to your partner, family, or trusted friends. They can provide emotional support and help you think through your options.

• Stay Informed:

Read up on the latest research, like studies mentioned by Dr. Allison S. Baker from MGH, and understand both the benefits and risks involved.

• Regular Monitoring:

If you decide to continue medication, ensure regular prenatal check-ups to monitor both your health and the baby’s development closely.

Final Thoughts: Empowering Your Choice

Trust yourself and your ability to make the best decision for you and your baby. It’s important to inform yourself, talk with people you trust, and collaborate with your doctor to make the best decision for you and your baby.

For more information listen to the  podcast episode on navigating ADHD treatment during pregnancy, where Dr. Allison S. Baker from MGH shares more insights.

Resources:

Allison Bakers Podcast

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References

Baker, A. S., & Freeman, M. P. (2018). Management of attention deficit hyperactivity disorder during pregnancy. Obstetrics and Gynecology Clinics of North America, 45(3), 495–509. https://doi.org/10.1016/j.ogc.2018.04.010

Bröms, G., Hernandez-Diaz, S., Huybrechts, K. F., Bateman, B. T., Reardon, P., Broe, A., Furu, K., Gíslason, T., Heiskanen, T., Källén, B., Kieler, H., Murray, E., Nielsen, H. S., Pasternak, B., Reichenberg, A., Svanström, J., & Wogelius, P. (2023). Atomoxetine in early pregnancy and the prevalence of major congenital malformations: A multinational study. The Journal of Clinical Psychiatry, 84(1), 22m14430. https://doi.org/10.4088/JCP.22m14430

Kittel-Schneider, S., Quednow, B. B., Leutritz, A. L., McNeill, R. V., & Reif, A. (2021). Parental ADHD in pregnancy and the postpartum period - A systematic review. Neuroscience and Biobehavioral Reviews, 124, 63–77. https://doi.org/10.1016/j.neubiorev.2021.01.002

Scoten, O., Tabi, K., Paquette, V., Carrion, P., Ryan, D., Radonjic, N. V., Whitham, E. A., & Hippman, C. (2024). Attention-deficit/hyperactivity disorder in the perinatal period. American Journal of Obstetrics & Gynecology, 24A. Retrieved July 2024, from https://www.ajog.org