Study: Discontinuing Stimulant Medication Negatively Impacts Pregnant Women with ADHD
Women with ADHD experience negative impacts on mood and family functioning when they discontinue stimulant medication use during pregnancy, according to a new observational cohort study that suggests medical professionals should consider overall functioning and mental health when offering treatment guidance to expectant mothers.
December 17, 2020
Women who discontinued stimulant medication use during pregnancy experienced a significant increase in postnatal depression despite not changing their antidepressant medication, as well as significant impairment in family functioning. These findings, published in the Journal of Attention Disorders1, come from the first study to characterize the course of attention deficit hyperactivity disorder (ADHD or ADD) during pregnancy, including treatment decisions and associated maternal outcomes. It suggests that medical professionals should consider overall functioning and mental health when offering ADHD treatment guidance to expectant mothers.
Twenty-five women with ADHD ages 18-45 were studied at <20 weeks, 24 weeks, and 36 weeks pregnant; researchers recorded which subjects discontinued, maintained, or adjusted their ADHD medications. The Adult ADHD Investigator Symptom Rating Scale (AISRS) was used to record ADHD symptoms at intervals. Depression, anxiety, stress and functional impairment were also monitored.
No significant differences were found in ADHD symptoms among the three groups of women who either discontinued, maintained, or adjusted ADHD medication. However, participants who discontinued psychostimulant treatment had significantly increased scores on the Edinburgh Postnatal Depression Scale (EPDS) despite not changing their antidepressant medication. These women also experienced significant impairment in family functioning, which meant they were “more likely to experience conflict within the family, have a harder time having fun as a family, rate parenting as more difficult, and describe being more isolated from their family.”
Such significant impacts suggest that ADHD symptom measurements alone are not a reliable indication of overall functioning when it comes to understanding whether discontinuation of stimulant medication during pregnancy may negatively affect women with ADHD. In the past, physicians have advised women to reconsider taking stimulant medication while pregnant based on “paucity of data, but this study highlights the importance and nuance of the risk-risk assessment when prescribing during pregnancy: weighing the risks of medication exposure during pregnancy with the risks of exposure to untreated psychiatric disorders.” According to the Federal Drug Administration, the stimulant medications used to treat ADHD are proven neither safe nor harmful for use during pregnancy, due to a lack of scientific research on human subjects.
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1Baker AS, Wales R, Noe O, Gaccione P, Freeman MP, Cohen LS. The Course of ADHD during Pregnancy. Journal of Attention Disorders. December 2020. doi:10.1177/1087054720975864