ADHD drug use in pregnancy increases risk of heart defects, study finds

The attention-deficit hyperactivity disorder drug methylphenidate is associated with an increased risk of heart defec...

Posted: Dec 13, 2017 3:21 PM
Updated: Dec 13, 2017 3:21 PM

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, which is the active ingredient in Ritalin, Concerta, Daytrana, Methylin and other ADHD medications.

First-trimester exposure to methylphenidate increased the risk of heart defects in infants by 28%

This risk translates to about 13 per every 1,000 births

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.

Worldwide, prevalence of ADHD has been estimated at about 3% in children, teens and adults. The use of these medications has increased by almost 800% between 1995 and 2015 among adults -- including women of reproductive age, one study finds.

With increasing use of stimulant medications during pregnancy, "there is an urgent need to better understand their safety," said Krista F. Huybrechts, lead author of the new study and an epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics at the Brigham and Women's Hospital.

To find answers, she and her co-researchers used nationwide data from Medicaid. Looking at 1.8 million pregnancies in the United States, they found that 35 infants per 1,000 were diagnosed with some form of congenital malformation, when the women did not take stimulants during pregnancy.

"In general cardiac defects occur in about 10 per 1,000 infants," noted Huybrechts.

Next, they looked at women who used either methylphenidate or amphetamines during all trimesters of pregnancy and compared the rates of congenital defects.

"If pregnant women take methylphenidate during the first trimester of pregnancy, they have a small increased risk of having a baby born with a cardiac malformation," Huybrechts said. "No such increase in risk was seen for amphetamines."

Next, the research team conducted a second analysis using data from an additional 2.6 million women who gave birth in the Nordic countries. This set of calculations supported the first: Though methylphenidate use during pregnancy was associated with heart defects in infants, use of amphetamines was not.

The risk of a cardiac defect appears to increase from 10 per 1,000 births to about 13 per 1,000 births when the mother used methylphenidate during pregnancy, Huybrechts said.

Dr. William O. Cooper, a pharmacoepidemiologist at the Vanderbilt University School of Medicine, reviewed the research and wrote an editorial in JAMA Psychiatry.

The new study used "appropriately rigorous methods," said Cooper, who was not involved in the research.

"Like many prescription medications, little is known about the effects of stimulant medications on pregnancy outcomes and fetal outcomes," Cooper wrote. "These results make an important contribution to the question of the safety of methylphenidate and amphetamine use during pregnancy."

Huybrechts emphasized that cardiac malformations are a serious but rare outcome -- even among pregnant women taking methylphenidate.

Pregnant women as well as young women who might get pregnant need to consider the evidence when "weighing the potential risks and benefits of different treatment strategies for ADHD," Huybrechts said. "This risk would have to be weighed against the risks associated with discontinuing treatment during pregnancy when symptoms are severe and interfere significantly with daily functioning."

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 1011197

Reported Deaths: 16524
CountyCasesDeaths
Marion1359292129
Lake666181167
Allen58254802
Hamilton46498467
St. Joseph44559617
Elkhart36044510
Vanderburgh32333481
Tippecanoe28037260
Johnson25196446
Hendricks23960360
Porter22985367
Madison18820410
Clark18609253
Vigo17530303
Monroe15319200
LaPorte15230252
Delaware15127264
Howard14801290
Kosciusko12410149
Hancock11773176
Bartholomew11695180
Warrick11305189
Floyd11138215
Wayne11023253
Grant10131220
Morgan9506177
Boone8965116
Dubois8281131
Henry8252153
Dearborn823493
Noble8064106
Marshall7981135
Cass7556123
Lawrence7479172
Shelby7216119
Jackson700990
Gibson6614115
Harrison651892
Huntington6447100
Knox6427106
DeKalb6363100
Montgomery6293112
Miami595298
Putnam584179
Clinton579271
Whitley568455
Steuben566876
Wabash5363104
Jasper536180
Jefferson513297
Ripley501987
Adams483777
Daviess4684115
Scott439875
Greene427296
Clay426960
Wells426088
White420964
Decatur4177104
Fayette407387
Jennings390262
Posey377544
LaGrange361778
Washington360451
Randolph3476100
Spencer340743
Fountain336160
Sullivan330852
Starke319171
Owen315571
Fulton313468
Orange295064
Jay285546
Franklin266443
Perry265752
Rush263832
Carroll262434
Vermillion259854
Parke232029
Pike229643
Tipton229059
Blackford195042
Pulaski184657
Crawford160125
Newton159848
Benton151217
Brown147047
Martin139319
Switzerland135311
Warren121416
Union107216
Ohio84613
Unassigned0544

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1524169

Reported Deaths: 23955
CountyCasesDeaths
Franklin1646591696
Cuyahoga1468932459
Hamilton1056051431
Montgomery742551279
Summit620221111
Lucas56539917
Butler51696718
Stark468601064
Lorain35783585
Warren32903377
Mahoning30927693
Clermont28271330
Lake27179448
Delaware24263164
Licking24027294
Trumbull22993561
Fairfield22438247
Greene22414326
Medina22149313
Clark19920354
Richland18643292
Portage18073252
Wood17505224
Allen16054279
Miami15627306
Muskingum14890185
Columbiana14153274
Wayne13852271
Tuscarawas12777311
Marion12016180
Scioto11497162
Pickaway11386142
Erie10951184
Ross10614203
Ashtabula9809204
Lawrence9783153
Hancock9741155
Belmont9333209
Geauga9008157
Jefferson8600199
Huron8427143
Union822259
Washington8114144
Sandusky7875151
Athens779579
Knox7766144
Darke7695158
Seneca7405145
Ashland6993130
Auglaize681799
Shelby6540115
Brown640091
Crawford6292130
Defiance6241105
Mercer617893
Fulton605196
Highland602899
Guernsey596371
Madison595678
Logan594596
Clinton585193
Preble5730125
Putnam5354110
Williams530888
Perry519863
Champaign514273
Jackson512473
Ottawa490586
Coshocton488383
Morrow460558
Pike435067
Fayette430363
Hardin420780
Gallia419367
Adams417995
Van Wert374082
Henry366972
Holmes3653125
Hocking357582
Wyandot325262
Carroll304365
Paulding280747
Meigs267251
Monroe216254
Noble201247
Morgan194333
Harrison182646
Vinton167225
Unassigned05
Fort Wayne
Partly Cloudy
45° wxIcon
Hi: 54° Lo: 42°
Feels Like: 40°
Angola
Partly Cloudy
45° wxIcon
Hi: 52° Lo: 39°
Feels Like: 41°
Huntington
Partly Cloudy
45° wxIcon
Hi: 54° Lo: 41°
Feels Like: 40°
Decatur
Partly Cloudy
45° wxIcon
Hi: 54° Lo: 42°
Feels Like: 40°
Van Wert
Partly Cloudy
45° wxIcon
Hi: 53° Lo: 42°
Feels Like: 40°
After a soggy couple of days, the sunshine returns Tuesday and highs top out in the middle 50s.
WFFT Radar
WFFT Temperatures
WFFT National

Community Events