Psych Congress NetworkStimulant Treatment for ADHD Safe to Continue During Pregnancy

A Closer Look at ADHD Medication Safety and Neurodevelopmental Outcomes

Recent research published in JAMA Psychiatry provides new insights into the safety of continuing stimulant medication for ADHD during pregnancy. This comprehensive cohort study examines the association between in utero exposure to ADHD medications and the risk of neurodevelopmental disorders in children, offering crucial information for clinicians managing pregnant patients with ADHD.

Key Points:

• The study analyzed health care utilization data from two large US databases, focusing on pregnant individuals covered by Medicaid (2000-2018) and those with commercial insurance (2003-2020).
• Researchers monitored children exposed in utero to amphetamine/dextroamphetamine or methylphenidate until they were diagnosed with a condition, disenrolled, died, or reached the study’s end.
• Key outcomes included the risk of autism spectrum disorder (ASD), ADHD, and any neurodevelopmental disorder in children following in utero exposure to ADHD medications.
• The analysis revealed no significant association between in utero exposure to amphetamine/dextroamphetamine and the risk of ASD, ADHD, or any neurodevelopmental disorder.
• However, methylphenidate exposure was associated with an increased risk of ADHD in children but not with ASD or any other neurodevelopmental disorder.
• Sensitivity analyses, considering maternal ADHD and stricter confounding factors, indicated that the association between methylphenidate exposure and child ADHD might not be robust.
• The study acknowledges limitations, such as potential inaccuracies in medication consumption and outcome classification, emphasizing the need for cautious interpretation of the results.

According to the CDC, the estimated number of children aged 3–17 years ever diagnosed with ADHD, according to a national survey of parents, is 6 million (9.8%) using data from 2016-2019.

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