Girls with attention-deficit/hyperactivity dysfunction (ADHD) typically discontinue ADHD drugs throughout being pregnant, particularly if they’ve milder signs. Whereas this method is sensible by way of limiting pointless exposures in ladies with milder sickness, we have now typically been stunned by scientific outcomes on this inhabitants, particularly when ladies who had been beforehand excessive functioning expertise vital psychiatric morbidity throughout being pregnant after discontinuation of ADHD drugs. Supporting these scientific observations is a new research study from our program which signifies that girls who cease ADHD drugs throughout being pregnant usually tend to expertise vital impairment in household functioning and better ranges of depressive signs.
Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor that’s used to deal with ADHD. Sometimes, we have now advisable discontinuing this remedy throughout being pregnant as a result of there was sparse knowledge relating to the reproductive security of this remedy. A brand new research consists of knowledge from a lot of atomoxetine-exposed pregnancies and means that atomoxetine could also be an inexpensive choice for the remedy of ADHD throughout being pregnant.
This research included about 2.4 million pregnancies ending in stay delivery recorded within the population-based nationwide well being registers of Denmark, Iceland, Norway, and Sweden (2003-2017) and roughly 1.8 million publicly insured pregnancies ending in stay delivery recorded within the US Medicaid Analytic eXtract (MAX, 2001-2013) well being care claims database. The evaluation in contrast the prevalence of main congenital malformations amongst pregnancies uncovered and unexposed to atomoxetine.
A complete of 990 pregnancies with first trimester publicity to atomoxetine had been recognized: 368 from the 4 Nordic international locations and 622 from the US. The pooled crude prevalence ratio (PR) for any main congenital malformation was 1.18 (95% CI, 0.88-1.60), and the adjusted PR was 0.99 (95% CI, 0.74-1.34). For cardiac malformations, the adjusted PR was 1.34 (95% CI, 0.86-2.09). For limb malformations, the adjusted PR was 0.90 (95% CI, 0.38-2.16).
Is Atomoxetine an Possibility for Girls Throughout Being pregnant?
Based mostly on this huge cohort research together with 990 pregnancies with first trimester publicity to atomoxetine, the researchers noticed no improve in main congenital malformations general and no statistically elevated danger estimates for cardiac or limb malformations. This data will undoubtedly be very reassuring to ladies who’re handled with atomoxetine.
Ruta Nonacs, MD PhD
Bröms G, Hernandez-Diaz S, Huybrechts KF, Bateman BT, Kristiansen EB, Einarsdóttir Ok, Engeland A, Furu Ok, Gissler M, Karlsson P, Klungsøyr Ok, Lahesmaa-Korpinen AM, Mogun H, Nørgaard M, Reutfors J, Sørensen HT, Zoega H, Kieler H. Atomoxetine in Early Pregnancy and the Prevalence of Major Congenital Malformations: A Multinational Study. J Clin Psychiatry. 2023 Jan 16;84(1):22m14430. Free article.
