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ADHD & pregnancy.. Help?
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macyd07 posted:
I'm new to this forum, but thought I'd ask my own question since I've Googled, yahoo-ed, searched all over and haven't found a real answer. I have ADHD and am newly pregnant .. need suggestions or thoughts on the situation!

Before being diagnosed, I've suffered from anxiety issues since I can remember. It was even extreme enough that I was (mis)diagnosed with "anorexia of some sort" by a doctor when I was SEVEN, yes 7. All because I didn't feel well when it was time to eat. I've dealt with this anxiety since then... so uncomfortable that I can barely do anything without getting up 20 times or just outright leaving, examples: sit through school, job interviews, church, basically anything over approximately 10 minutes (sometimes that's too long). My family doctor gave me Xanax when I was around 15...and of course that helped with anxiety, but also made me insanely tired and unproductive, but I took it because how else could I stay socially normal? (You can only find enough excuses to leave situations before people start thinking you are strange. ...and I was called weird because of my constant fidgeting, inability to pay attention, my "flakiness," constantly changing my mind about decisions ... etc
You get the point if you have ADD/ADHD).

A doctor mentioned ADD/ADHD to my parents a few times, but was dismissed because by miracle I still managed extremely good grades.

At 23, when my daughter was 2 and I was practically abusing Xanax and similar drugs just to "survive" a life with her and be able to function normally as a mom. (You can't really just jump up and dash out of a Target when when you need diapers like right NOW and I've been known to leave a cart of groceries behind because I couldn't bear the thought of standing 5 minutes in line. IT WAS UNTHINKABLE).

So at 23, they re-diagnosed me appropriately with ADHD .. (hyperactivity accounted for all the "anxiety" I was feeling and of course then makes up for all the unexplained unpredictable random behaviors).. and almost immediately after starting on Adderall, I didn't need Xanax. I actually held a job for 8 months (company relocated), I stayed a year sober without any alcohol (self medication in social situations to keep me calm), was no longer lethargic, made appointments, got things accomplished.... like FOR REAL? the rest of the world get to live like this?? and I've suffered something no one wanted to acknowledge for 20+years?

POINT OF THIS LONG POST:
I am now pregnant with my second child.. after reading everything, I'm not really comfortable staying on the drug, but doctors have been literally NO help. No one has offered me an alternative .. and they suggested I stay on it because the benefit out weighs the risk (probably?)

I want to "live", I don't want to damage my child ... and there's no way I can keep up with a 5 year old and be pregnant without medication. I'll be single in nine months--doubt anyone could handle me like that! In a sense adderall is my life, which sucks...but somewhat true

I guess I'm just wondering if anyone else has taken it throughout their pregnancy ... any suggestions of alternatives I could talk to my doctor about? Just thoughts...? It's not a common conversations to talk among friends ... "so yes, I'm taking adderall during my pregnancy.." So I decided to post on here. Just looking to hear some feedback, negative or positive ...

Thanks, Maci
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An_239558 responded:
Hello Maci,
I dont have an answer to your questions, but wanted to let you know that there is someone else is out there... i am right there with you on this!
I am not pregnant yet....but everything you posted is why i am not yet..Married only a year but getting close to 35, My life cannot stop. I dont have the anxiety as severe but (but i am sure it could there) everything else you said is as if i wrote your post.

I would like to know if you find something to help you, and i will let you know if i find anything. I totally understand where you are coming from.

Good Luck,
Stacy
 
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Gina Pera responded:
HI Maci,

First of all, congratulations!

My research indicates this question has a very mixed-bag of answers. It's a difficult area to study, and the existing research examines special populations such as drug-addicted mothers. The bottom-line answer is: It depends.

You can read a summary of professional opinion here at a webpage of Massachusetts General Hospital (an internationally recognized center of ADHD research):

http://www.womensmentalhealth.org/posts/clinical-update-use-of-stimulant-medications-in-pregnancy/

The research in drug-addicted women shows that the stimulants do cross the placenta and enter the fetal circulation.

That said, the experts I've interviewed do NOT see stimulants as an absolute contraindiction for pregnant women with ADHD. Rather, it is a relative contraindiction. That is, it depends on the woman's situation and symptom severity.

As you can imagine, the "side effects" of untreated ADHD in an expectant mother can be considerable, too. Think stress hormones, constant frustration, overeating/undereating, and even greater risk of car accidents. Each woman must weigh the risk-benefits with her doctor.

Some experts have pointed to evidence suggesting that older formulations used to treat ADHD, such as nortriptyline, might be safer options.

Overall, I encourage young women with ADHD who are considering getting pregnant to do everything BEFORE they conceive to make their lives easier during pregnancy and after, thus mitigating the need for medication. That means, for example:

1. saving up money to hire help when needed
2. eating well to create a healthy store of vitamins/minerals for the fetus (whose neurological system's foundation is laid almost at conception and depends on these nutrient stores) and ensure a healthier pregnancy.
3. setting up organizational systems and supports

I hope this helps,
Gina Pera
 
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macyd07 replied to An_239558's response:
23 weeks, baby is healthy as far as any tests can detect.. found out I'm having a boy. I'm still on adderall, (sorry to the whole internet world that doesn't want to admit that or will look down upon me for it). I do not take the original dose that I was on, but I still take a smaller dose, and I should note that it no longer has the same amazing effects that it did when I was not pregnant.

I listened to the doctors with the risks vs. benefits.. and of course ANY pregnancy is a lower risk when there is nothing artificial involved.. but the risks of adderall aren't all that bad. I couldn't lie to myself and tell the doctors that I could go 9 months without anything.. unless I was confined to my house. Literally, I am not exaggerating. Someone on the outside of this may look at me and think "I'm just using that as an excuse.. " but no.. I'm literally mentally disabled and incapable of functioning without something to manage my anxiety and etc.. The major risks with the adderall are all weight related.. a concern of course but doctors are watching closely to the baby's weight and growth. Everything is so far so good

Contrary to what I would think, the xanax has much worse effects on the baby than what adderall would have..

I would tell you if you can, to drop it before getting pregnant, but if you can't, talk to you doctors. I'm functioning on this lower dose, being a mother to my daughter still.. I'll let you know more in the future

Maci
 
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livnbetter replied to macyd07's response:
Thanks so much for keeping me posted!!
 
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dgcore responded:
Maci,

I am 29 and about 6 weeks along with my second child and I am prescribed 20 mg of methylphenidate. I go to my doctor today and see if she will try to knock me down to maybe 10 mg a day. I see most of you take adderall and not methylphenidate. Is there a reason? Do doctors think the risk is lower with the adderall perphaps?
I myself feel very guilty when i take it but I also know that i would be a complete mess without it as well. I wouldn't get anything done and I probably wouldn't remember anything at that point either haha. I wish their was more info for pregnant women and ADHD but at this point it is up to us. Im scared that my hormones will take over and send me into a deep depression which could harm the baby worse due to my impulsive behaviors. Just know you are not alone in this! I was so refreshed to read this and see their are other women going through the same struggle and choices as I am. Stay strong everyone we have to stick together. Congrats as well:)
 
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macyd07 replied to dgcore's response:
Sorry, I don't sign into this often, but I'll try to keep updated as it comes..
As I already said, the adderall seems to have less of an effect as the pregnancy progresses... kind of like being doomed into feeling mentally incapable of functioning for the remainder of my pregnancy...
I just went to the doctor today, heart rate is normal for the baby (something that adderall could affect) and the baby is measuring normal.. results for the ultrasound also normal.
We talked about the adderall again, because I always have concerns.. and he basically weighed it out for me (he's known me a long time).. he said he has seen me on the drug and off the drug and for me the benefit is far outweighing the risk.. it's all individual. To dgcore, for me, it's basically, would I be more of a risk if my anxiety and other issues were full blown than if I were kept on a small dose throughout the pregnancy. I have no idea about methylphenidate.. have never tired it.. I've been prescribed adderall from the beginning

I will update occasionally, because I haven't seen many post that they stayed on adderall through pregnancy.

(I of course am not a doctor, but am just publicly writing my experience. )
 
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komittedsgurl replied to macyd07's response:
I am 26 and have ADD. I am also on adderal and i am the same way you are. I really cant go off of it other wise my world gets all messed up and i get anxiety, depressed and basically cant function. now recently they are putting on my bottle the pregnancy warning lables on there.
I went off my birth control and never noticed a change in my medicine and how it makes me feel. but with in the last two weeks when i take it I cant get off my butt. I just sit there thinking. it doesnt work like it use to but yet I still can tell im on it. I take Adderall 20 Mg 3x a day but due to a shortage they switched me to 15 Mg 4x a day. but I have been only taking 15 to 30 Mg a day.
My biggest concern is that I am possibly pregnant and if I am what complications is it going to cause? I also don't eat like I should and I also have other health issues so if I was and the adderall would harm the kid I would like to prevent that.
I guess what I am trying to ask is that did you notice a huge difference on how the medicine worked once you became pregnant? if you could help me out.
 
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macyd07 replied to livnbetter's response:
happy to announce, full term pregnancy, actually an additional week, they induced me at 41 weeks, I had a healthy baby boy w no complications, 8lbs 2oz, perfect in every way
 
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livnbetter replied to macyd07's response:
Congrats!!! That Great news!!

Did you stay on adderall the whole time? what dose? Did your Son have any withdrawal effects or did they give him something for that?

Thank you so much for remembering to keep my posted, you dont know how relieved i am.

take care
 
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sngkoroll replied to livnbetter's response:
Thank you for posting this; I am an executive with an extremely demmanding job that requires long hours and it is essential for me to remain on medication to be productive.
I am in corporate real estate/investment banking and at a critical point in my pregnancy - not planned but happy about it_ as I am 8 weeks but also only four months into a National Director's position at a new firm.
Performance at work will be critical for not only me to maintain my job but more importantly to keep my anxiety and depression at bay - both products of my ADHD.
I am currnetlly on Vyvanse and very hesitant to speak with may doctor about my prescription and condition as they will demand I stop all drugs. I had to discontinue Pristiq which has aggravated both my depression and anxiety - in turn my focus has obviously been affected.
Any thoughts on alternatives/ways to deal with this with the medical community, particularly in a State like Texas where these prescriptions are INSANELY monitored, would be helpful and so appreciated.
 
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macyd07 replied to livnbetter's response:
Turns out, I suck at checking this site since I'm not worrying about the problem, but here's an update: and before I begin, I will say, I am not offering any advice, I am just giving my experience because I couldn't find anyone else's honest experience with adderall and pregnancy online...
My son experienced no withdrawal effects from the dose I was on. I was weaned down to 10mg x 2 at the very end but I'm small, so I'm not sure how the 10mg compares with my body weight. I took the it throughout the entire pregnancy.. right up to the day that I went to the hospital. It was kind of like at that point, I didn't want to remove something from my body.. but I will say that I don't think the adderall had the same effect as it did before pregnancy. It certainly didn't keep me focused, and I would be lying if I told you I never took like 20mg at once .. because I did. So I don't think it was the dose, I'm pretty sure it went with the pregnancy. I never felt clear minded, always a little off, even the few times I tried 20mg in once dose. ..My pregnancy went a week over, 41 weeks.. and I had a healthy baby boy that has been an extrememly happy&calm baby. He is now almost 6 months old, healthy.. 100 percentile in height and about 75 in weight...

In summary...
Adderall was never banned by my doctor, although he certainly told me that it would be best if I went without it. He warned me of the known potential side effects and possible issues.... the biggest were: low birth weight, premature birth, and similar to caffiene:a crabby, cranky, not good at sleeping baby...
In my situation, ..I lowered my dosage to 10mg x 2 a day by the end of my pregnancy. The drug lost a lot of it's effect, but it still did a little.. My son was not premature, but one week late.. he was not underweight and is at the 100th percentile in height and up in weight, and he is neither crabby or a bad sleeper...

so like my doctor told me, you need to decide if the risk outweighs the benefit.. what is better for you as an individul in the situation... and let the doctors monitor the baby appropriately for risks you are imposing on the pregnancy.

If this doesn't make sense, I'm typing with a sleeping baby in one arm, so I hope you all get the main point of it.

I'll check this email more often too, promise
 
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livnbetter replied to macyd07's response:
Awesome New!!

Thanks
 
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elainebenice replied to sngkoroll's response:
I am so happy I found this thread!! I too am on ADHD meds, Vyvanse and Dexedrine. I just turned 35 and feel like its basically "now or never" for me to start trying to get pregnant. I have been on birth control since I was 18 or so due to very heavy periods with severe cramping, which pretty much every woman in my family has been cursed with as well. I am an attorney and have a very stressful/demanding job, so I began taking ADHD meds about 5 years ago...probably longer if I'm honest. As others have mentioned and I'm sure many know, my productivity and effectiveness in my job improved dramatically once I started taking meds, which doesn't lend itself to a desire to stop taking the meds.

I decided to stop my birth control about 5 or 6 months ago, but I am have not stopped my ADHD meds and am not sure I can....at least not stop and still function. I would never want to expose my unborn child to anything that could potentially harm them, but I am really worried about going off of my meds for 9 months. I know people are probably reading this thinking I'm just addicted to my meds and I can/should stop taking them like anyone else breaks and addiction (and they're probably correct about being addicted), but its not as easy as it sounds, especially when your job depends on being alert and mentally sharp while putting in crazy numbers of hours each week.

I guess I don't have any questions or anything helpful to offer, but I just wanted to say how relieved I am to know I'm not the only person going through this battle. Please keep the updates and info coming for those of us still in the beginning stages of this process. Thanks so much!!
 
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3warmwildeyes replied to macyd07's response:
Hi Im not sure if you still check this post, but I am so happy to have found it. As you can see you are definitely not alone.

I have been prescribed to Adderall & Xanex off & on since I was 14. Both for ADD & anxiety & also to help regulate my sleep schedule. I have never had a sleep study done but Im convinced I have a circadian rhythm disorder. Basically my body wont follow a socially acceptable sleep/wake schedule or even a manageable one. If not properly medicated my "bedtime" comes later & later until I eventually find myself not being able to fall asleep until late in the afternoon. Thats when I have to make myself stay up for sometimes days at a time until I can fall asleep at the right time of the day to try to bring my bedtime back to a more "normal" hour. That works for a little while but the cycle always continues & it leaves me very exhausted & foggy all the time. It has been completely debilitating & I have always had a very hard time holding down a job. It has effected my relationships & makes it almost impossible to function at all. The good news is that the Adderall & Xanex has worked wonders for me & allowed me to have a "normal" life. The bad news is that when I stop taking them, it doesnt take long at all for everything to go to crao again & I turn into a crazy emotional disfunctional wreck. Which is definitely not very condusive to raising childten or keeping the father around. So for me I really dont think going off of them is an option. But I do have fears about how it will effect my future children. I am so happy to hear that your baby is happy & healthy but I was wondering if you breastfed while on the meds? And if so did your baby suffer any withdrawal symptoms when you stopped? I have read that with most drugs only a very small, almost insignificant percentage of the drug is actually passed through the milk. But it seems there are not very many studies with actual conclusive results to be found about this.Im just so happy to hear from an actual mother with experience in this situation. Please keep us updated on the progress of you & your baby!! It looks like you posted last about 2 years ago so Im guessing your son is about 2.5-3 by now? Have you noticed any developmental issues,hyperactivity, lethargy or any other behavioral issues as he has gotten older? I hope you are not offended by these questions. You just seem willing to give honest answers about this, which is hard to find & is exactly what I need (along with many other women like us) I know you were looking for answers when you originally posted this. But now you are the one REALLY helping so many women coming after you. So thank you VERY much <3


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