The Effects of Drugs used for the Treatment of Attention Deficit Hyperactivity Disorder (ADHD) on Pregnancy Outcome and Breast-feeding: A Critical Review

(E-pub Ahead of Print)

Author(s): Asher Ornoy*, Gideon Koren

Journal Name: Current Neuropharmacology


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Abstract:

Attention deficit/hyperactivity disorder (ADHD) is a neurobehavioral condition found in 5-10% of school age children and in 2-5% of adults. Stimulants, affecting the dopaminergic, noradrenergic and/or serotonergic systems are commonly used for treatment in children and adults, including women of child bearing age. The data on the effects of stimulants (methylphenidate and amphetamines) in pregnancy are generally reassuring but methylphenidate might slightly increase the rate of cardiac malformations and of spontaneous abortions, while amphetamines might slightly increase the risk for premature birth, low birth weight and other pregnancy complications. Bupropion, a dopamine and norepinephrine reuptake inhibitor, when used as an antidepressant appears to be safe in pregnancy. The data on the use of atomoxetine, guanfacine and clonidine in pregnancy are scarce. Importantly, there are practically no data on the long-term neurodevelopmental effects of most of these drugs. The published data on the development of children born to methamphetamine- abusing women may be misleading since these women generally use other drugs including alcohol and the home environment where the child is raised may not be optimal. The treating physician should judge the need of treatment during pregnancy in relation to the severity of the clinical symptoms. If needed, methylphenidate is preferred over amphetamines because breast feeding is possible. If one uses non-stimulant medications bupropion seems to be the preferred drug.

Keywords: ADHD, pregnancy outcome, drugs, stimulants, complications of pregnancy

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Article Details

Published on: 27 November, 2020
(E-pub Ahead of Print)
DOI: 10.2174/1570159X18666201127164000
Price: $95

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