Maintaining executive function in pregnancy

January 22, 2021 6:55 PM

Do you know of any prescribers in NYC who write prescriptions for Strattera/Atomoxetine to pregnant people? Alternatively, do you know of any studies that exist for pregnant people taking atomoxetine to provide data for future people who depend on this medication to maintain and control my focus?

I'm a cis woman with severe ADHD and Complex PTSD trying to become pregnant. My current prescriber does not prescribe Strattera/Atomoxetine to pregnant people and strongly prefers not to prescribe to people trying to become pregnant. While I understand her reasoning, I cannot face the prospect of months without the ability to have more than a sliver of control over my focus.

I am not currently pregnant, but am trying. At my age and with my medical history, there is no guarantee that I can get pregnant.

This medication combined with the group and individual therapy I am in have done the most for my depression of anything I have tried for over 2 decades.

(The Mount Sinai ADHD clinic sent me the name of one provider in private practice who specializes in adolescent psychiatry, so the Mt Sinai ADHD med management team exists but is not looking promising)

posted by bilabial to Health & Fitness (7 answers total)

There are some clinics/psychiatrists that specialize in "reproductive psychiatry." (From googling, I see that there are a few in NYC.) A friend sought one out for consult when she was trying to evaluate how to deal with psych meds during her pregnancy. Presumably, if it's safe/safe enough for it to be a wise choice for you to take during pregnancy, people in that specialty would be informed enough to feel comfortable prescribing it.
posted by needs more cowbell at 8:22 PM on January 22, 2021 [3 favorites]

My wife flew out to Boston from Chicago to participate in a study out of Mass General Hospital. She did not take the above drugs, she was taking adderall, and she wanted 1) to participate in research regarding this and 2) wanted a competent reproductive psychiatrist. This was precovid, and we had the money to do so. So the logistics would be much harder, and I'm unsure if something like that would be a viable option for you but that's how we handled the situation.
posted by AlexiaSky at 9:19 PM on January 22, 2021 [1 favorite]

Do you have a relationship with an OBGYN? I would suggest finding an OBGYN and discussing these concerns with them; my OB was willing to prescribe things my other providers would not while I was pregnant. If you want the name of my Columbia OBGYN, drop me a DM.
posted by ThePinkSuperhero at 9:35 PM on January 22, 2021 [4 favorites]

I ended up going to see a reproductive psychiatrist at the Stanford clinic mentioned in this question. Knowing I'd seen someone at a research center moved my psychiatrist from reluctant to fine with prescribing adderall. So you might not need to see a repoductive psych specialist on an ongoing basis (and I'm not sure how many do ongoing care vs consults, although I didn't have to look into it much). Of course is your psych is dead set against it, it might be easier to find a repro psych who will see you on an ongoing basis.

Also, this doesn't directly answer your question, but I found the MGH Center for Women's Mental Health blog helpful when dealing with similar issues.
posted by matildatakesovertheworld at 10:37 PM on January 22, 2021 [3 favorites]

I'm a physician who treats pregnant women who take prescription and nonprescription drugs. NOT your physician.
Your being in NY makes things much more difficult as the medical malpractice environment for physicians and especially OBGYNS makes them extremely conservative (and obgyns are conservative about this at baseline). I would do some research yourself on mothertobaby.org and see if any of the contributors to that excellent site practice near you.
posted by genmonster at 10:13 AM on January 23, 2021

IANYP. You could probably go to any psychiatrist who has experience in "reproductive psychiatry" or "women's mental health" and they would have the comfort and experience in prescribing medications in the peripartum period. It looks like Mount Sinai does have a division in reproductive psychiatry, so it might be more appropriate to be seen there instead of the ADHD clinic. MGH has a study (they might be recruiting?) on pregnant women taking ADHD medications.
Lactmed is a database of medications and information on safety in pregnancy and breastfeeding.
posted by gemutlichkeit at 12:56 PM on January 23, 2021 [1 favorite]

This registry does not include any studies on atomoxetine, but here is a list of pregnancy exposure registries for a variety of medications (including some ADHD meds).
posted by gemutlichkeit at 5:35 PM on February 1, 2021