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Continuing ADHD Treatment During Pregnancy May Help Patients Better Manage OUD
Pregnant patients with comorbid attention-deficit/hyperactivity disorder (ADHD) and opioid use disorder (OUD) who remain on their ADHD medications throughout pregnancy are more likely to adhere to OUD treatment and less likely to overdose than patients who stop taking ADHD medication, according to results published in Nature Mental Health.
“Treatment of ADHD is a huge knowledge gap in obstetrics and even more so in patients with substance use disorder,” said study author Jeannie Kelly, MD, associate professor of obstetrics and gynecology at Washington University. “In obstetrics, a knowledge gap frequently leads to reluctance to treat because of unknown risks to the fetus. However, it’s also really important to discuss the risks of not treating, because untreated disease also can have huge implications for mom’s and baby’s health.”
>>QUIZ: How many symptoms must be present in order to diagnose adult ADHD?
Researchers used de-identified prescription and Medicaid databases to examine 3247 pregnant people initiating OUD treatment, of whom 5% (168) received psychostimulants. The 168 patients were receiving methadone or buprenorphine for OUD treatment and also taking ADHD medications. Researchers analyzed how long the patients maintained their OUD treatments and how often they required emergency care due to opioid use.
Patients who continued with their ADHD medications stayed on buprenorphine for roughly 2 months longer than patients no longer taking ADHD medication. Researchers also found that emergency room (ER) visits were reduced in patients who continued ADHD treatment: 41% of patients who continued their ADHD treatments went to the ER versus 54% of those who stopped. Authors theorized that this result is because ADHD medications help with impulsivity, which may have allowed patients to better manage their substance use treatment.
