With coverage of safety of ADHD meds in pregnancy, a need to get the facts straight

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If you’ve been reading my blog these last few months, you know that a critical issue to me is the safety — or lack thereof — of ADHD women continuing to take medication, including and especially CNS stimulants, while pregnant. Having always wanted to be a mom, I previously reported that if circumstances align and I do end up in a position to make such a decision, I would opt to continue to take my primary stimulant medication, dexmethylphenidate (aka Focalin) during the nine months of pregnancy.

I realize that this is a relatively controversial decision; the reasoning behind it can be found in my original post on the subject. In any case, I recently learned that the guilt-in-advance I sometimes experienced as a result of this decision may not be warranted, as a study published in the journal Obstetrics & Gynecology found, “The risks associated with taking an ADHD stimulant medication during pregnancy are real, but quite small.”

Specifically, according to the study authors, “Psychostimulant use during pregnancy was associated with a small increased relative risk of preeclampsia and preterm birth,” however, “The absolute increases in risks are small and, thus, women with significant ADHD should not be counseled to suspend their ADHD treatment based on these findings.”

Naturally, I was over the moon to find out that I may be able to do what I’ve always wanted — become a mother — without my ADHD getting in the way. But my happiness was short-lived, because the other day, I came upon a CNN article with the headline “ADHD drug use  in pregnancy increases heart defects, study finds.” 

It begins:

The attention-deficit hyperactivity disorder drug methylphenidate is associated with an increased risk of heart defects in infants whose mothers take the medication during pregnancy, according to a study published Wednesday in the journal JAMA Psychiatry. […] Specifically, the researchers found a 28% increased prevalence of cardiac malformations after first-trimester exposure to the stimulant. 

It continues:

To manage ADHD, doctors commonly prescribe methylphenidate and other stimulants, including amphetamines known as Adderall, Dexedrine, Dyanavel, Evekeo, ProCentra and Vyvanse. However, amphetamines were not found to increase the risk of heart defects, the study concluded.

Being on dexmethylphenidate, though, I nevertheless freaked out in the numb sort of way that comes with receiving the same shock over and over.

But I soon found out that all was not as it seemed. 

In a post on Forbes, contributor Tara Haelle explained that the risk “translated to 3 additional infants per 1,000 women born with heart defects,” however, “That finding … was also borderline statistically significant, which means it appears to be a real risk but was very close to being a chance finding.”

Furthermore, 

It’s very difficult to study the possible effects of different medications taken during pregnancy because birth defects already occur very rarely. That means a study must include a very large population of children to look for slight differences in the birth defect rate. In addition, the researchers have to take into account all the differences between women who do and don’t take specific medications that might also play a role in the risk of birth defects. It’s impossible to account for every possible factor, so researchers select a group of factors that seem most likely to have a potential influence on risk.

Essentially, the same study that caused the folks over at CNN to declare Ritalin and other iterations of methylphenidate unsafe to take during the first trimester of pregnancy only gave a writer over at Forbes slight pause.

Essentially, the same study that caused the folks over at CNN to declare Ritalin and other iterations of methylphenidate unsafe to take during the first trimester of pregnancy only gave a writer over at Forbes slight pause. Click To Tweet

The salient point here is that women who encountered the CNN article but not the Forbes one could theoretically be deterred from continuing to take their medication during pregnancy — even if their ADHD is severe — even though that may in fact not be necessary or even safe.

Real people are consuming these media and said media can have a real impact on their lives. For that reason, it’s of paramount importance that newsmakers do their due diligence and verify the claims they report on before clicking “publish.” 

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