Management of Attention Deficit Hyperactivity Disorder During Pregnancy

Baker, Allison S.; Freeman, Marlene P.

doi:10.1016/j.ogc.2018.04.010

Cited by 16 publications

(17 citation statements)

References 27 publications

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“…While MPH does not seem to have teratogenic properties, there are concerns regarding risk of miscarriages, cardiac malformations, deceleration of fetal growth, as well as preterm birth and placenta-associated pregnancy complications (e.g., preeclampsia). However, the available evidence is largely inconclusive, since the absolute risk of the above-mentioned adverse outcomes remains hard to estimate (Baker and Freeman 2018 ; Koren et al 2020 ; Li et al 2020 ; Poulton et al 2018 ).…”

Section: Clinical Considerationsmentioning

confidence: 99%

Methylphenidate for attention-deficit/hyperactivity disorder in adults: a narrative review

2021

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Rationale Psychostimulants, including methylphenidate (MPH), are the mainstay of pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD) in adults. Even though MPH is the most commonly used medication for ADHD these days, there are relatively few resources available that provide comprehensive insight into the pharmacological and clinical features of the compound. Objective The aim of this paper is to provide an up-to-date outline of the pharmacology and clinical utility of MPH for ADHD in adult patients. Methods While conducting the narrative review, we applied structured search strategies covering the two major online databases (MEDLINE and Cochrane Central Register of Controlled Trials). In addition, we performed handsearching of reference lists of relevant papers. Results Methylphenidate exhibits multimodal mechanism of action, working primarily as a dopamine and noradrenaline reuptake inhibitor. It also protects the dopaminergic system against the ongoing ‘wearing off’ (by securing a substantial reserve pool of the neurotransmitter, stored in the presynaptic vesicles). In placebo-controlled trials, MPH was shown to be moderately effective both against the core ADHD symptoms (standardized mean difference [SMD], 0.49; 95% confidence interval [CI], 0.35–0.64), and the accompanying emotion regulation deficits (SMD, 0.34; 95% CI, 0.23–0.45). The most common adverse events related to long-term treatment with MPH are decreased appetite (~ 20%), dry mouth (15%), heart palpitations (13%), gastrointestinal infections (~ 10%), and agitation/feeling restless (~ 10%). Conclusions There is substantial body of evidence to suggest that MPH is an effective and safe treatment option for adults with ADHD.

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Section: Clinical Considerationsmentioning

confidence: 99%

Methylphenidate for attention-deficit/hyperactivity disorder in adults: a narrative review

2021

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“…As the drug is also not recommended in ADHD treatment it should therefore be avoided (Damkier & Broe, 2020). Even if some studies suggested a low risk for cardiovascular malformations due to methylphenidate and amphetamine treatment (Huybrechts et al, 2018; see also follwing meta-analysis: Jiang, Zhang, Jiang, & Fu, 2019;Källén et al, 2013) and a low risk for CNS-related disorders of the infant (Nörby et al, 2017) as well as an increased but still low risk for specific birth defects (such as gastroschisis, omphalocele, and transverse limb deficiency) (Kayla N. , these risks are so low that medication should not be stopped if the ADHD is so severe that the treatment is necessary for daily functioning of the affected women (see also : Baker & Freeman, 2018;Bolea-Alamanac et al, 2014). The teratogenic effects of atomoxetine and guanfacine have not been systematically investigated, so no conclusions can be drawn yet.…”

Section: Adhd Medications Seem Not To Be Major Teratogensmentioning

confidence: 99%

Parental ADHD in pregnancy and the postpartum period – A systematic review

Kittel‐Schneider

Quednow

Leutritz

et al. 2021

Neuroscience & Biobehavioral Reviews

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“…Among reproductive age women, 3% of women have ADHD and in cases of moderate to severe impairment, the benefits of prescription stimulant use may outweigh risks. 125 In 2015, 1% of reproductive age women reported prescription stimulant misuse. 1 Prescription misuse effect on pregnancy-Very little is known about prescription misuse of stimulants.…”

Section: Methamphetaminesmentioning

confidence: 99%

Stimulant Use in Pregnancy: An Under-recognized Epidemic Among Pregnant Women

Smid

Metz

Gordon

2019

Clinical Obstetrics &Amp; Gynecology

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Stimulant use, including cocaine, methamphetamines, ecstasy, and prescription stimulants, in pregnancy is increasingly common. In the US, stimulants are the second most widely used and abused substances during pregnancy and pregnant women using stimulants in pregnancy are at increased risk of adverse perinatal, neonatal, and childhood outcomes. In this review, we describe the pharmacology, pathophysiology and epidemiology of stimulants, summarize the maternal and neonatal effects of perinatal stimulant use, and outline treatment options for stimulant use disorders among pregnant women. Development of effective treatment strategies for stimulant use disorders identified among pregnant women are urgently needed.

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Management of Attention Deficit Hyperactivity Disorder During Pregnancy

Cited by 16 publications

References 27 publications

Methylphenidate for attention-deficit/hyperactivity disorder in adults: a narrative review

Methylphenidate for attention-deficit/hyperactivity disorder in adults: a narrative review

Parental ADHD in pregnancy and the postpartum period – A systematic review

Stimulant Use in Pregnancy: An Under-recognized Epidemic Among Pregnant Women

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