Pharmacological Treatment of Attention Deficit Hyperactivity Disorder During Pregnancy and Lactation

Ornoy, Asher

doi:10.1007/s11095-017-2323-z

Cited by 35 publications

(16 citation statements)

References 82 publications

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“…Two safety reports with maternal age over 35 years and additional confounders for spontaneous abortion were reported: a 41-year-old woman using dienogestestradiol and ibuprofen (co-reported drugs as confounders) (12)(13)(14), and a 36-year-old woman using vortioxetine, lisdexamfetamine, and valacyclovir (coreported drugs and underlying diseases for which these were prescribed as confounders) (12,(15)(16)(17)(18). Three other safety reports of spontaneous abortion confounded by the use of other drugs occurred in younger women, two on erenumab and one on fremanezumab.…”

Section: Foetal Adverse Drug Reactionsmentioning

confidence: 99%

Safety profile of erenumab, galcanezumab and fremanezumab in pregnancy and lactation: Analysis of the WHO pharmacovigilance database

et al. 2021

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Objective To assess the safety profile of erenumab, galcanezumab and fremanezumab in pregnancy and lactation. Methods Safety reports of suspected adverse drug reactions were retrieved from VigiBase as of 31 December 2019, for a case-by-case assessment and disproportionality analysis using the reporting odds ratio (ROR). Results There were 94 safety reports: 50 (53.2%) on erenumab, 31 (33.0%) on galcanezumab, and 13 (13.8%) on fremanezumab. In five (5.3%) safety reports, drug exposure occurred prior to pregnancy, in 85 (90.4%) during pregnancy, in one (1.1%) during lactation, in one (1.1%) via paternal exposure, and in two (2.1%) the exposure time was unknown. Out of 94 safety reports, 51 (54.3%) consisted only of drug exposure, while 43 (45.7%) additionally reported 47 adverse drug reactions including maternal toxicities (n = 18), poor breastfeeding (n = 1), spontaneous abortion (n = 23), preterm birth/prematurity (n = 3), and birth defects (n = 2). There was no signal of disproportionate reporting for spontaneous abortion compared to the full database (reporting odds ratio 1.46, 95% confidence interval 0.97–2.20). When triptans were used as a comparator group, a signal of disproportionate reporting for spontaneous abortion was detected in association with erenumab, galcanezumab, and fremanezumab (reporting odds ratio 1.86, 95% confidence interval 1.12–3.13), which was not statistically significant after excluding confounded safety reports (reporting odds ratio 1.21, 95% confidence interval 0.67–2.21). Conclusions No specific maternal toxicities, patterns of major birth defects, or increased reporting of spontaneous abortion were found. However, because of the relatively limited number of adverse drug reactions reported and the lack of long-term safety data, continuous surveillance is required in pregnant and lactating women exposed to these drugs.

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Section: Foetal Adverse Drug Reactionsmentioning

confidence: 99%

Safety profile of erenumab, galcanezumab and fremanezumab in pregnancy and lactation: Analysis of the WHO pharmacovigilance database

et al. 2021

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“…Notably, breastfeeding is not considered as contraindication for treatment with MPH, since just a very small fraction of the drug is secreted in milk (making MPH undetectable in the infant’s serum) (Ornoy 2018 ; U.S. National Library of Medicine 2020 ).…”

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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“…10 -12 In recent years, there has been a steady increase in ADHD medication use by young adults, including women of childbearing age and during pregnancy. [13][14][15][16][17][18][19][20][21][22] This increase has been reported in several countries, including Canada, the UK, and the USA. In Canada, there was more than a fourfold increase in the prevalence of ADHD medication prescriptions in adults, from 0.32% in 2005 to 1.29% in 2015.…”

Section: Introductionmentioning

confidence: 81%

“…Untreated ADHD impacts the individual's well‐being as well as their psychosocial health, and is associated with important professional and psychosocial outcomes 10‐12 . In recent years, there has been a steady increase in ADHD medication use by young adults, including women of childbearing age and during pregnancy 13‐22 . This increase has been reported in several countries, including Canada, the UK, and the USA.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and determinants of attention deficit/hyperactivity disorder (ADHD) medication use during pregnancy: Results from the Quebec Pregnancy/Children Cohort

Lemelin

Boukhris

Zhao

et al. 2021

Pharmacology Res & Perspec

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Pharmacological Treatment of Attention Deficit Hyperactivity Disorder During Pregnancy and Lactation

Cited by 35 publications

References 82 publications

Safety profile of erenumab, galcanezumab and fremanezumab in pregnancy and lactation: Analysis of the WHO pharmacovigilance database

Safety profile of erenumab, galcanezumab and fremanezumab in pregnancy and lactation: Analysis of the WHO pharmacovigilance database

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

Prevalence and determinants of attention deficit/hyperactivity disorder (ADHD) medication use during pregnancy: Results from the Quebec Pregnancy/Children Cohort

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