Did you or anyone you know take ADHD meds during pregnancy?
April 4, 2016 10:31 AM   Subscribe

And if so, did the baby turn out okay? (I'm considering kids, but am terrified by the prospect of going off my dexedrine. I'm pretty convinced I'd lose my job without it. Does this mean I just shouldn't get pregnant? Or can I keep taking my meds if I do?)

I tried asking my ob/gyn and she told me that there aren't really great studies on this, because you can't exactly take a group of pregnant women and give some of them dexedrine and see what happens. To the extent that there are any studies, it looks like they're mostly on meth addicts, which is a whole other story - way higher dosage, different body chemistry to begin with.

Long story short: the doc had no real data but tried to scare me away from it with "if anything happens you'll never forgive yourself". (Which seriously, eff her, that's a horrible thing to say regardless.) My husband thinks it'd be fine and that I should feel comfortable taking my meds if I get pregnant and basically supports any choice I make. And me, I'm just a big bundle of uninformed nerves and fear in every direction. I crave more data!

So, I'm looking for anecdotes. Did you or anyone you know take ADHD meds during pregnancy? If so, did the baby turn out okay?
posted by anonymous to Health & Fitness (13 answers total) 3 users marked this as a favorite
Here is a recent scholarly article about this topic. I hope that someone is tracking the babies born to mothers who took ADHD meds throughout pregnancy. Your doctor didn't phrase that well, you wouldn't randomly give women some drug to see if it affected the baby but you can study women who already take a drug to see effects on baby.

I wonder if the hormonal changes of pregnancy have some effect on ADHD? I think maybe you need another doctor who will take your question more seriously.
posted by mareli at 11:26 AM on April 4, 2016 [2 favorites]

I know you said you were looking for anecdotes, but here's a study that might be of interest:

In particular: "The available literature on the therapeutic use of amphetamines in pregnancy suggests no increased risk of malformations. A prospective study evaluated the rate of congenital anomalies in children born to 1694 women using amphetamines as anorectics in pregnancy. When compared with a control group of 8989 women, the incidence of malformations was not increased."
posted by aecorwin at 11:27 AM on April 4, 2016

Anecdotal stories that other people's babies turned out ok don't give you much idea of the overall risk.

motherisk.org is a great resource on medications in pregnancy. You can also look up the product monograph for dexedrine and see what pregnancy risk category it's in.
posted by mossicle at 11:28 AM on April 4, 2016 [6 favorites]

Yes, I did.
Half my normal dose, but both my ob and my psych were OK with me continuing to take it.
It had no obvious impact on the baby who was a normal full-term birth and has hit all normal developmental milestones. Personally, were I to get pregnant again, I'd do it again.

That being said, I wasn't on dexedrine. Looks like it's category C, which is the same as my particular medication, so it is probably similar risk profile.

Everyone will give you the "if anything happens you'll never forgive yourself" schpiel for so many things during pregnancy. You have to decide what your risk tolerances are, what things you can't/won't budge on and what things you can budge on. I stopped things like ibuprofen (definitely in the 3rd trimester) but did not stop taking my adhd meds for workdays. I can't promise you your kid will be fine, but I think the odds of a low dose of adhd meds causing problems in an otherwise healthy pregnancy... they don't seem to be there, because if they were there, the drug would probably not be a category C. That obviously should be weighted by the number of people who take that drug and the number likely to keep taking it even when pregnant, etc etc. Hopefully you get my point.

Good luck.
posted by ch1x0r at 11:28 AM on April 4, 2016 [2 favorites]

Here's a link to a forum where a lady posted a similar question and got feedback/support, which you may want to check out.

There really doesn't seem to be a lot of literature out there, as your doctor says. But you should read the book Expecting Better, which has a section on drugs during pregnancy. Talks about evaluating the information for yourself and deciding what risk YOU are willing to accept.

It will help you understand that really, the most important thing for the baby is that the mom is doing well. If you're unable to function and can't maintain your job without the meds, well that's going to be a definite huge disadvantage for the baby... whereas the medical risks are not well-studied.
posted by lizbunny at 11:29 AM on April 4, 2016 [2 favorites]

So, amphetamines of that type were not heavily controlled until the 70s and I have a lot of anecdote from women my mother's age that they were prescribed them to control weight gain in pregnancy. But, like others have said, that's not your best source of information. I would try talking to a different OB/Gyn about the risks because there might not be great studies but there might be better information. I know there is one study of women who took amphetamines for weight control during pregnancy which linked the drugs to low birthweight.

You might talk to your ADHD medication prescribing doctor as well. Questions about mental health medications and pregnancy are getting a lot of traction these days, at long last. So, good luck!
posted by crush-onastick at 11:38 AM on April 4, 2016

I was told I absolutely could not continue my adderall prescription during pregnancy. I did okay without it, though the first trimester I slept every available moment. I relied on lots of coping mechanisms: to-do lists, calendars, alarms, reminders. My ADD is inattentive, so the main symptom I had to control was forgetting things.

I took considered risks with other things (soft cheeses, lunch meat), but I was not willing to take risks with adderall. Be cautious with side effects. For one thing, high blood pressure is not something you want to have while pregnant. Also, if you experience morning sickness, you may not also want an appetite suppressant on top of that.

I'd also be extremely careful about interactions with medical providers. Do you trust your ob/gyn team to support your choices? In some places, women are drug-tested when they deliver, and it's not impossible for you to be subject to charges, regardless of the legality of your prescription.
posted by Kitty Stardust at 11:47 AM on April 4, 2016

I did not take mine and I decaffinated myself as well. I functioned fine at my job. Both my kids are as ADD as I am.
posted by Ideefixe at 12:03 PM on April 4, 2016 [1 favorite]

I'm sorry that your doctor said that to you. A lot of people hear those same sorts of lines about their antidepressants and anti anxiety drugs and it's absolutely not based on any evidence, moreover, it's cruel and not in your best interest as their patient.

Did you know there are reproductive psychiatrists who specialize in managing psychiatric care for women who are trying to conceive, pregnant and/or breastfeeding? Recommend seeing if there is one in your area!
posted by treehorn+bunny at 12:11 PM on April 4, 2016 [9 favorites]

If you do decide to go off or lower your dose, I can offer the following observations I had while dating a person who had ADD and went off 45mg / dexedrine per day, cold-turkey and without telling anyone:

1. Taper off, don't go cold-turkey. Get small increments of your caplets and really taper the amount slowly, maybe over a couple months. Going cold turkey makes it hard to adapt to the sudden change in attention span, appetite, energy, etc- it causes all those changes to hit at once and the result is more chaotic than it needs to be.

2. Tell select people what you're doing (partner, employer, close friend at work). If people know why your behaviour is different they can be understanding, grant leeway, check in, and help you with coping mechanisms. That sounds like it might be annoying I guess, but from the other side: my ex didn't tell me a thing. I definitely noticed the difference in behaviour within 3 hours of the first dose they skipped, and within 12 hours, even acquaintances noticed the ADHD symptoms and commented on the behaviour in a critical way. This was really hurtful to the person and made them doubt their ability to ever function normally off the drug, but that was an unnecessary outcome. The real problem was just that everyone just thought the fidgeting, inattentiveness, interruptions and goofiness were a joke, so the behaviour seemed really annoying and caused conflict. Had anyone (even one person in each environment) known that the cause was medical, we could have been more patient, forgiving, and helpful, and nipped problems in the bud by redirecting many awkward moments.

3. Get good time management and attention-mastering habits in place for a few weeks before tapering off the dose. Get a watch, set it 15 minutes ahead, use a paper planner, commit religiously to writing things down, set reminder alarms, use to-do lists, start the pomodoro technique, exercise more, regiment your sleep schedule and sleep hygiene, stock up on healthy food since your appetite will balloon, etc. Your behaviour and functionality will change but it's maneageable- try to make it as easy on yourself as possible!

Good luck whatever you decide!
posted by pseudostrabismus at 1:26 PM on April 4, 2016

I'm trying to conceive, and have spent the past few months struggling with this question, myself. I don't have answers, but I do have the support of my doctors, and a plan for my (potential) pregnancy.

This wasn't easy. Both my ob/gyn and psychiatrist were initially against me being on medication, and informed me that I had to discontinue the Adderall. No more prescriptions.

At first, I was able to maintain the routines and organization without medication, but over time things began to go less smoothly, and I became increasingly distressed. I went back on meds, then off, trying to extend this time period.

We also tried a few other alternatives, that were semi-helpful. Eventually, my doctor agreed that the benefits of me being on medication outweighed the risks. To make this determination, I had to clearly document how I was impacted by being off the medication, and request a referral for a neonatal psychiatrist.

My current plan is to continue taking the Adderall until I get a positive pregnancy test. At that point, we'll see what pregnancy hormones due to my ADHD, and I'll take it (or an alternative) on an as-needed (or daily) basis.

I know this isn't an answer, and my plan has gone through modifications as our attempts to conceive have dragged on, but it's really about trying to find that personal balance between benefit and risk. My stability is important for the baby's future too!
posted by bindr at 4:50 PM on April 4, 2016

You might get similar info if you look at studies of caffeine intake. Have you considered upping your coffee intake? Also check studies of Wellbutrin outcomes. Totally, completely unreliable anecdata, however: a few moms I know who took antidepressants during pregnancy have just weird kids. Not clinically weird, just pretty darn odd. This is not something that is going to be measured by any studies.

That said, it's so frustrating when people tell you during pregnancy "No amount of x has been measured safe during pregnancy." Um, yeah, that's because we don't test things on pregnant women . . .

Also consider that your psychological profile may change during pregnancy. There are some women who experience better focus and better mood during pregnancy and can easily go off meds (and many who experience the opposite).

As for your job, you may have more workplace protections while pregnant depending on where you live, so they may be less inclined to terminate you.
posted by luckdragon at 6:49 AM on April 5, 2016

I apologize that this isn't directly answering your question, but if you live in the US, something you might want to look into and consider is whether your state has any so-called "fetal endangerment" laws. Women are being punished in ridiculous, draconian ways right now.

I'm sorry for the way your doctor responded to your totally legitimate questions. It's a sign that you might want to start interviewing new doctors.

(BTW, meth and dexedrine are virtually identical.)
posted by cowboy_sally at 6:47 PM on April 5, 2016

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