ADHD and pregnancy

Am J Psychiatry. 2014 Jul;171(7):723-8. doi: 10.1176/appi.ajp.2013.13050680.

Abstract

Attention deficit hyperactivity disorder (ADHD) has been increasingly recognized and treated in children and adults in recent years. As a result, a growing number of women enter their reproductive years treated with medication for ADHD or are diagnosed and start medication during their reproductive years. A common question in perinatal psychiatry regards the risk-benefit profile of pharmacotherapy for ADHD, particularly with stimulants. At this time, there are no guidelines to inform the treatment of ADHD across pregnancy and the postpartum period. Concerns about in utero exposure to stimulants are based primarily on the impact these medications might have on fetal growth. While stimulants do not appear to be associated with major congenital malformations, more human data regarding potential behavioral teratogenicity are needed in order to understand both the short- and long-term risks. Severity of illness, presence of comorbid disorders, and degree of impairment have an impact on treatment decisions. Crucial considerations include driving safety and ability to function in occupational roles. While most women can successfully avoid the use of stimulant medication during pregnancy, there are cases in which the benefits of stimulant treatment outweigh known and putative risks of in utero medication exposure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Bupropion / adverse effects
  • Bupropion / therapeutic use
  • Central Nervous System Stimulants / adverse effects*
  • Central Nervous System Stimulants / therapeutic use*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / drug therapy
  • Cognition Disorders / psychology
  • Combined Modality Therapy
  • Drug Substitution
  • Female
  • Humans
  • Infant, Newborn
  • Neuropsychological Tests
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / psychology
  • Psychotherapy
  • Puerperal Disorders / diagnosis
  • Puerperal Disorders / drug therapy
  • Puerperal Disorders / psychology
  • Referral and Consultation
  • Risk Factors

Substances

  • Central Nervous System Stimulants
  • Bupropion