Is It Safe During Pregnancy Or For Children
The FDA classify Concerta and other forms of methylphenidate as pregnancy class C drugs. This means that some animal studies have shown that they present a danger to the fetus, but that there are not enough studies in humans to determine the effect.
In studies of rats, high doses of methylphenidate have caused birth defects and other negative outcomes.
In some cases, the benefits of methylphenidate may outweigh the risks, but a person must consult with their doctor before determining the best course of action.
Researchers do not know whether infants can come into contact with Concerta through breast milk.
The FDA have approved Concerta for use in children ages 6 and older, but not in younger children.
Concerta is not the only option for treating ADHD. People who do not have good results from Concerta may see improvements after taking a different stimulant or a different combination of medications.
Some people with ADHD choose nonstimulant drugs, such as atomoxetine , guanfacine , or clonidine . Other drugs, such as antidepressants, may also help.
Beyond medication, people with ADHD may benefit from treatments such as family and behavioral therapy, as well as accommodations at work or school and lifestyle changes, such as sticking to a regular routine.
The American Academy of Pediatrics recommend that parents and caregivers of children with ADHD pursue a treatment that involves both therapy and stimulants, rather than medication alone.
The Effect Of Adhd Medication Use On The Mother
Adults with ADHD usually function well on medication. Off medication, hyperactivity, distractibility, and impulsivity can lead to marital strife, poor job performance, and social problems. And lets not forget problems with organization of thoughts, activities, and time the nexus at which life can fall apart. This dilemma almost always occurs with ADHD and pregnancy, or nursing.
Its critical to weigh the effect on the mother of ceasing ADHD medication, considering what little is known about the impact of such medications on the fetus and, later, the baby. Your obstetrician will be able to provide you with literature on medications taken during pregnancy.
After pregnancy, your pediatrician will be able to provide you with literature on medications taken while breastfeeding. Even though physicians have even less data on the impact of ADHD medications during nursing than with their use during pregnancy, read this literature. Then think through how seriously you might need the ADHD medication during the nine months of pregnancy and additional months of breastfeeding and caring for a small child who requires constant, vigilant attention.
Each mother must discuss these issues with her physician and make her own decision. With this little research, There is no easy answer. You, your doctors, and your partner must weigh all the information and make the best decision for your family.
Is Concerta Safe To Use While Pregnant Or Breastfeeding
- The safety of methylphenidate for use during human pregnancy has not been established. There are no adequate and well-controlled studies in pregnant women. Concerta should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- It is not known whether methylphenidate is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised if Concerta is administered to a nursing woman.
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Adhd Drug Tied To Heart Defects In Babies
By Lisa Rapaport, Reuters Health
4 Min Read
– – Pregnant women who take drugs like Ritalin and Concerta for attention deficit hyperactivity disorder are more likely than those who dont to have babies with heart deformities and other birth defects, a recent study suggests.
Researchers examined data on more than 1.8 million pregnancies in the U.S., including 2,072 women who used methylphenidate and 5,571 who took an amphetamine during their first trimester.
Overall, women who took methylphenidate were 11 percent more likely to have a baby with birth defects and 28 percent more likely to have infants with heart malformations than women who didnt take stimulants for ADHD during pregnancy.
There was no increased risk of birth defects in general or heart malformations specifically with amphetamines like Adderall, the researchers found.
Our findings suggest that there might be a small increase in the risk of cardiac malformations associated with intrauterine exposure to methylphenidate, said lead study author Krista Huybrechts of Harvard Medical School and Brigham and Womens Hospital in Boston.
Although the absolute risk is small, it is nevertheless important evidence to consider when weighing the potential risks and benefits of different treatment strategies for ADHD in young women of reproductive age and in pregnant women, Huybrechts said by email.
All of the women in the current study had health insurance through Medicaid, the U.S. benefits program for the poor.
First Trimester In Utero Exposure To Methylphenidate
Dorthe Dideriksen
Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Jesper Hallas
Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Clinical Pharmacology, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
Per Damkier
Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Clinical Pharmacology, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
Dorthe Dideriksen
Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Jesper Hallas
Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Clinical Pharmacology, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
Per Damkier
Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Clinical Pharmacology, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Safety Of Adderall During Pregnancy
Adderall can be a godsend for relieving your ADHD symptoms so feel free to give a woohoo! for modern medicine. But as effective as it may be when theres no bun in your oven, the general consensus in the medical community is that Adderall and pregnancy shouldnt mix.
Adderall stimulates the nervous system, and besides the unpleasant side effects listed above, it also increases the risk of psychosis, heart attack, stroke, and even death. These risks are serious all on their own, but even more so when the lives of both mother and baby are at stake.
Despite this general guidance, though, there may be certain situations where taking Adderall during pregnancy could be the best choice. Given the side effects, a pregnant woman would only take Adderall if the benefits outweighed the risks to the baby, explains Dr. Sherry A. Ross, an OB-GYN at Providence Saint Johns Medical Center in Santa Monica, California.
If a pregnant woman was unable to care for herself or her growing baby due to severe and disruptive ADHD symptoms, she may be prescribed Adderall for the benefits to her and, ultimately, her baby.
Exceptions during pregnancy aside, if youre planning to breastfeed, youll need to continue to stay off of Adderall its not recommended for nursing mothers. Since the drug can pass through breast milk, it may cause undesirable symptoms in your baby, such as:
- loss of appetite
- insomnia
- failure to thrive
Research On Adhd Medications Impact On Pregnancy And Breastfeeding
Clinicians once believed that the placenta served as a barrier that protected the fetus from the adverse effects of medications and toxins taken by the mother. This is wrong. We now know that medication can pass through the placenta to the fetus. However, researchers from the FDA and Centers for Disease Control among others are still working to obtain a clear understanding of the effects of psychotropic medicine on a child in utero and/or while breastfeeding.
For example, the C.D.Cs program, Treating for Two aims to improve the health of women and babies by identifying the safest treatment options for common conditions before, during, and after pregnancy.1
Treating for Two is now accumulating and publishing current research studies regarding medication use during pregnancies. One ADHD-related research study appears in their Key Findings section. One such study, published in the Journal of Attention Disorders in 2018, found that the rate of women taking ADHD medication during pregnancy more than doubled between 1998 and 2011.2 Though lacking evidence about the risks of stimulant use during pregnancy or nursing, this study confirms the need for concentrated research for women making prenatal health decisions.
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Drug Forms And Administration
Concerta is available as a long-acting tablet thats taken by mouth, in the morning. Concerta is available in the following strengths:
- 18 mg
- 36 mg
- 54 mg
Your dosage of Concerta will depend on your age and certain ADHD treatments that you may have used in the past. For more information about dosages of Concerta, see the Concerta dosage section above.
Adderall is also taken by mouth, usually once to three times each day.
Adderall is available in two forms: an immediate-release tablet and an extended-release tablet . Like Concerta, Adderall XR releases the medication over time. But the immediate-release form of Adderall releases the medication all at once.
Adderall is available in the following strengths:
- 5 mg
What Is The Dosage For Concerta
General Dosing Information
Concerta should be administered orally once daily in the morning with or without food.
Concerta must be swallowed whole with the aid of liquids, and must not be chewed, divided, or crushed.
Patients New To Methylphenidate
The recommended starting dose of Concerta for patients who are not currently taking methylphenidate or stimulants other than methylphenidate is 18 mg once daily for children and adolescents and 18 or 36 mg once daily for adults .
Table 1. Concerta Recommended Starting Doses and Dose Ranges
| Patient Age |
Other methylphenidate regimens: Clinical judgment should be used when selecting the starting dose.
Dose Titration
Doses may be increased in 18 mg increments at weekly intervals for patients who have not achieved an optimal response at a lower dose. Daily dosages above 54 mg in children and 72 mg in adolescents have not been studied and are not recommended. Daily dosages above 72 mg in adults are not recommended.
A 27 mg dosage strength is available for physicians who wish to prescribe between the 18 mg and 36 mg dosages.
Maintenance/Extended Treatment
There is no body of evidence available from controlled trials to indicate how long the patient with ADHD should be treated with Concerta. It is generally agreed, however, that pharmacological treatment of ADHD may be needed for extended periods.
Dose Reduction and Discontinuation
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What Causes Limb Reduction Defects
The cause of limb reduction defects is unknown. However, research has shown that certain behaviors or exposures during pregnancy can increase the risk of having a baby with a limb reduction defect. These include:
- Exposure of the mother to certain chemicals or viruses while she is pregnant
- Exposure of the mother to certain medications
- Possible exposure of the mother to tobacco smoking
CDC works with many researchers to study risk factors that can increase the chance of having a baby with limb reduction defects, as well as outcomes of babies with the defect. Following are examples of what this research has found:
- A woman taking multivitamins before she gets pregnant might decrease her risk for having a baby with limb reduction defects, although more research is needed.2
- Certain sets of limb reduction defects might be associated with other birth defects, such as heart defects, omphalocele, and gastroschisis.3
What Problems Do Children With Limb Reduction Defects Have
Babies and children with limb reduction defects will face various issues and difficulties, but the extent of these will depend on the location and size of the reduction. Some potential difficulties and problems include:
- Difficulties with normal development such as motor skills
- Needing assistance with daily activities such as self-care
- Limitations with certain movements, sports, or activities
- Potential emotional and social issues because of physical appearance
Specific treatment for limb reduction defects will be determined by the childs doctor, based on things like the childs age, the extent and type of defect, and the childs tolerance for certain medications, procedures, and therapies.
The overall goal for treatment of limb reduction defects is to provide the child with a limb that has proper function and appearance. Treatment can vary for each child. Potential treatments include:
- Prosthetics
- Surgery
- Rehabilitation
It is important to remember that some babies and children with limb reductions will have some difficulties and limitations throughout life, but with proper treatment and care they can live long, healthy, and productive lives.
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Taking Concerta With Food
Concerta can be taken with or without food. In clinical trials, Concerta worked the same way when it was taken with a big meal as it did when it was taken on an empty stomach.
If Concerta upsets your stomach or causes nausea, it may be better for you to take it with food. Taking the medication with food in your stomach can reduce these side effects.
Who Can And Cannot Take Methylphenidate
Methylphenidate can be taken by most adults. However, it is not suitable for everyone.
Tell your doctor before starting the medicine if you:
- have ever had an allergic reaction to methylphenidate or any other medicine
- have difficulty swallowing some brands may not be suitable for you
- have heart problems
- have epilepsy
- have tics , or a family history of Tourette’s syndrome
- have glaucoma or are at risk of getting glaucoma
- are trying to get pregnant, are already pregnant or breastfeeding
- have problems with drugs or alcohol
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Ceasing Use Of Adhd Medication During Pregnancy And Breastfeeding
When a mother decides to stop taking ADHD medication during pregnancy and/or nursing, its helpful for her to educate her spouse or partner, other children, extended family members, and employer about this decision. Symptoms of hyperactivity, inattention, and/or impulsivity may return during pregnancy, and may take some people off guard.
Explain that you are stopping medication because you feel its best for your baby, and welcome any support they can offer bringing over some meals, reminding you of appointments, etc. You may also want to consider decreasing or eliminating certain responsibilities.
Use Of Adhd Medicine Is Increasing Among Pregnant Women
A study from the Centers for Disease Control and Prevention found that an increasing number of pregnant women are taking attention-deficit/hyperactivity disorder medicine. The study also found that women who took ADHD medicine during early pregnancy may be more likely to have a baby with some types of birth defects compared to women who did not take ADHD medicine. This is among the first few studies to look at ADHD medicine use among pregnant women and risk for individual birth defects. More research is needed to determine the safest treatment options for managing symptoms of ADHD during pregnancy.
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What Drugs Interact With Concerta
MAO Inhibitors
Concerta should not be used in patients being treated with MAO inhibitors.
Vasopressor Agents
- Because of possible increases in blood pressure, Concerta should be used cautiously with vasopressor agents.
Coumarin Anticoagulants, Antidepressants, And Selective Serotonin Reuptake Inhibitors
- Human pharmacologic studies have shown that methylphenidate may inhibit the metabolism of coumarin anticoagulants, anticonvulsants , and some antidepressants .
- Downward dose adjustment of these drugs may be required when given concomitantly with methylphenidate. It may be necessary to adjust the dosage and monitor plasma drug concentrations , when initiating or discontinuing concomitant methylphenidate.
Risperidone
- Combined use of methylphenidate with risperidone when there is a change, whether an increase or decrease, in dosage of either or both medications, may increase the risk of extrapyramidal symptoms . Monitor for signs of EPS.
Adhd Treatment Alternatives During Pregnancy
No doubt, it can be a serious bummer to learn that your go-to med for ADHD is off the table during your pregnancy. So what can you do when conventional drug treatment isnt an option?
Fortunately, you do have choices. Your doctor may refer you to a counselor or psychologist who can use talk therapy to help you develop skills for managing ADHD symptoms.
You might also experiment with various relaxation techniques like yoga, massage, or meditation. One small showed that people with ADHD who practiced mindfulness meditation saw improvement in emotional regulation.
Exercise can be another low-risk prescription for pregnant women with ADHD. A showed people with ADHD had better reaction times and made fewer errors on tests when they engaged in physical activity.
Consult your doctor about what types of exercise might be safe for you during pregnancy.
Some people with ADHD also benefit from antidepressants, specifically the tricyclic variety, which are believed to stimulate norepinephrine in the brain. As a treatment alternative, your provider may prescribe an antidepressant thats compatible with pregnancy.
Finally, its possible that your doctor may decide the benefits of staying on Adderall are greater than the risks of going off of it. If this is the case, you may simply end up with more tests and scans throughout your pregnancy to make sure baby is healthy and growing appropriately.
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New Findings Regarding The Reproductive Safety Of Adhd Medications Within Pregnant Woman
A Danish registry-based study of 364,012 singleton pregnancies adds to our understanding of stimulant reproductive safety. Researchers used redeemed prescriptions from the Danish Health Services Prescription Database to identify ADHD medication exposures in pregnancies that occurred between November 1, 2007, and February 1, 2014.
The Danish Fetal Medicine Database was used to identify significant malformations during pregnancy, and the Danish National Patient Registry was used to identify them after birth. Pregnancies with no redeemed ADHD medication prescriptions comprised the comparison group.
A new Danish registry-based study compared psychiatric medication for ADHD and birth defects using health-care credentials. According to the researchers, the defects were discovered only in pregnancies with more than one qualified prescription redeemed.
The majority of first-trimester exposure to ADHD drugs ranged from 0.05 percent in 2008 to 0.27 percent in 2013, with methylphenidate accounting for the vast majority of these exposures. 5.1 percent of pregnancies were associated with significant malformations in the exposed group, compared to 4.6 percent in the control group.
ADHD medications appear to be safe for pregnant mothers, as 2.1 percent of those who used the drug had a child with a heart defect, compared to 1 percent of those who were not exposed.
There is insufficient evidence to conclude that the drugs are dangerous for pregnant people or have a history of heart defects.
