Stimulants- WHY are they unsafe?

kells621

This is not to perpetuate any false information, because I did find a study where they studied around 2 million pregnant women and found no signifcant risks for malformations when pregnant mothers used amphetamines, and only borderline significant risks when mothers used methylphenidate. (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2664964)

But for the people who are against taking stimulants, what is it about stimulants that are harmful to the baby? 

For example, I take adderall, but I think I could apply these questions to caffeine and other stimulants.  Is it unsafe for pregnancy because it raises heart rate, which raises the baby's heart rate? And then, why is it bad to raise the baby's heart rate? (Exercise raises your heart rate while you're doing it).. Or does it have to do with dopamine? It's somehow interfering with the baby's future ability to create dopamine because I'm burning through it?

Different doctors have different opinions, so it's not necessarily as easy as just asking your doctor.  

kiki75

kells621 said:

This is not to perpetuate any false information, because I did find a study where they studied around 2 million pregnant women and found no signifcant risks for malformations when pregnant mothers used amphetamines, and only borderline significant risks when mothers used methylphenidate. (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2664964)

But for the people who are against taking stimulants, what is it about stimulants that are harmful to the baby? 

For example, I take adderall, but I think I could apply these questions to caffeine and other stimulants.  Is it unsafe for pregnancy because it raises heart rate, which raises the baby's heart rate? And then, why is it bad to raise the baby's heart rate? (Exercise raises your heart rate while you're doing it).. Or does it have to do with dopamine? It's somehow interfering with the baby's future ability to create dopamine because I'm burning through it?

Different doctors have different opinions, so it's not necessarily as easy as just asking your doctor.  

I doubt many people are going to want to spend their time compiling the research you seem to be looking for. If you’re that interested, zip on down to your local library and do the research.

harpseal135

Let's just say, any stimulant (caffeine, adderall,  etc) isnr something that is natural to the body.  If you have ever seen a newborn in withdrawal stage after birth, you will know why most doctors are against that stuff while pregnant     

kells621

I’m  just asking in case anyone has any information, (anecdotal or otherwise), that I haven’t encountered.  I have spent a lot of time researching. It would be silly to believe that any one person, including a doctor, would ever reach the end of all the research or stories about a topic on their own. This is one of my pet peeves..  If you have nothing of value to offer, there’s no need to reply. That’s what an online forum is for. Crowdsourcing. You click on the post if you’re  interested or have something to add. The poster understands there’s a good chance nobody will, but it’s just in case. 

kiki75

kells621 said:

I’m  just asking in case anyone has any information, (anecdotal or otherwise), that I haven’t encountered.  I have spent a lot of time researching. It would be silly to believe that any one person, including a doctor, would ever reach the end of all the research or stories about a topic on their own. This is one of my pet peeves..  If you have nothing of value to offer, there’s no need to reply. That’s what an online forum is for. Crowdsourcing. You click on the post if you’re  interested or have something to add. The poster understands there’s a good chance nobody will, but it’s just in case. 

It pretty much sounded like you were hoping for an argument. Bingo! I was letting you know, you’re likely barking up the wrong tree. On both fronts. Do whatever it is you’re going to do. FX for that baby. 

meggyme

kells621 said:

*Snip*
  If you have nothing of value to offer, there’s no need to reply. That’s what an online forum is for. Crowdsourcing. You click on the post if you’re  interested or have something to add. The poster understands there’s a good chance nobody will, but it’s just in case. 

That’s not how the internet works. Anyone that wants to post something can. Just because you don’t want to read it doesn’t mean they can’t post it.

As for your question, most people don’t drink coffee or exercise 24/7, and I’d imagine most stimulants are time released. That would lead to an elevated heart rate and raised blood pressure all the time which is not good for a small, newly developing heart. And many are habit forming, as PP mentioned.

If you’ve read actual research I don’t know why you’d be looking for anecdotal stories. That’s bound to be even less conclusive than whatever studies you’ve read. And any medication should be discussed with your doctor to determine if the risks outweigh the benefits.

kells621

Sorry, I didn't mean to imply that people *can't* or aren't *allowed* to reply. I was just meaning to suggest that it wasn't helpful.  Since I can't expect anyone to read my mind, and so nobody has to waste their time, I'm clarifying that my post in particular isn't looking for advice to contact my doctor, because I already have that taken care of. So you don't waste your time, I'm informing you that the intentions of MY post is for crowd sourcing rather than to receive your opinion about whether I should be crowd sourcing.  Of course you're *allowed* to post a reply with your opinion or whatever you want. 

loveallthings

kells621 said:

Sorry, I didn't mean to imply that people *can't* or aren't *allowed* to reply. I was just meaning to suggest that it wasn't helpful.  Since I can't expect anyone to read my mind, and so nobody has to waste their time, I'm clarifying that my post in particular isn't looking for advice to contact my doctor, because I already have that taken care of. So you don't waste your time, I'm informing you that the intentions of MY post is for crowd sourcing rather than to receive your opinion about whether I should be crowd sourcing.  Of course you're *allowed* to post a reply with your opinion or whatever you want. 

Nice backtrack. 😂

kells621

I just want to add an update in case anyone ever stumbles upon this post and is interested.  I had a phone conversation with another one of my doctors. She's a well respected high risk/MFM specialist.She said nothing more than a google search can tell you-they simply can't recommend adderall because there's not enough research.  But there's also no evidence that it's bad, or specifically HOW it would affect a baby. She wasn't avidly against it, and said if I feel that I need it then it's fine. This has NOTHING to do with her competence. No doctor knows everything, doctors are not Gods, and I respect my doctor, who is humble enough to say "I don't have enough information". So after asking this doctor, I'm back to square one. If you're somebody who has already heard about specific research related to this from YOUR doctor or someone you find relevant, I'd like to hear it. Maybe I can then show MY doctor, who is not above hearing new information.

harpseal135

kells621 said:

I just want to add an update in case anyone ever stumbles upon this post and is interested.  I had a phone conversation with another one of my doctors. She's a well respected high risk/MFM specialist.She said nothing more than a google search can tell you-they simply can't recommend adderall because there's not enough research.  But there's also no evidence that it's bad, or specifically HOW it would affect a baby. She wasn't avidly against it, and said if I feel that I need it then it's fine. This has NOTHING to do with her competence. No doctor knows everything, doctors are not Gods, and I respect my doctor, who is humble enough to say "I don't have enough information". So after asking this doctor, I'm back to square one. If you're somebody who has already heard about specific research related to this from YOUR doctor or someone you find relevant, I'd like to hear it. Maybe I can then show MY doctor, who is not above hearing new information.

Seriously!?! Your doctor already told you there is not enough research.

The reason there is not enough research is because it would be UNETHICAL to run a true study knowing a group of 'known' pregnant ladies are on stimulants and give birth to kids who have affects vs. known placebo group who have no stimulants and no adverse affects.  

Sorry, but you wont find what you are looking for. Your doctor even told you  

suzycupcake

kells621 said:

I have spent a lot of time researching. It would be silly to believe that any one person, including a doctor, would ever reach the end of all the research or stories about a topic on their own. 

*lurrrrrrrrrrrk*

One of my pet peeves. Someone who says they've spent a lot of time researching but doesn't know the answer to their own question. If no one person or a doctor could ever reach the end of all the research, then what's your question? It seems like you just want an argument because your mind is already dead set on continuing with the medication. 

delujm0

What research were you doing, OP?  Are you a medical professional with access to relevant medical studies (which are not published in full for free online, you need paid access to medical journals to get to them)? Are you from a research background, educated in how to interpret medical studies to determine bias or shortcomings in the procedures used?  Or did you just do some googling?

Your doctor may not know it all, but she knows more than you most likely, because she has access to information that you don't have access to and she's been trained on how to interpret it.  Almost no medication is given a conclusive all clear for pregnant women because that can only happen with a randomized medical study, which would be unethical to carry out on a group of pregnant women.  All you will see is studies based on anecdotal information voluntarily provided by pregnant women who have used a substance, which isn't really enough to draw a reliable conclusion on.

I'd do what your doctor advises.  Avoid the stimulant if you are able to, use it only when absolutely necessary.

jrm_14

kells621 said:

**snip**
She said nothing more than a google search can tell you-they simply can't recommend adderall because there's not enough research.  But there's also no evidence that it's bad, or specifically HOW it would affect a baby. She wasn't avidly against it, and said if I feel that I need it then it's fine. This has NOTHING to do with her competence. No doctor knows everything, doctors are not Gods, and I respect my doctor, who is humble enough to say "I don't have enough information".
::snip::

OP, what I’m hearing you say is that there isn’t any information about the medication being harmful. Therefore, you’re willing to take the risk. 
Storytime:
I was on a medication that didn’t have any research saying it was harmful to a developing baby or how it may impact baby. Great- right?  Wrong. Lack of information on harmful side effects =/= safe =/= proof it doesn’t hurt developing baby. Tw-loss
Fast forward to losing 3 babies & having IF issues. Data eventually comes out the medication that had little to no research now shows it DOES have harmful fertility side effects. 

From now on, I will be sticking with meds that show proof of not being harmful rather than meds that don’t have proof of being harmful. There’s a major difference. 

Bringmemylongswordho

kells621

It would be unethical to lead a study by asking pregnant women to take stimulants, but it's not unethical to compile data and study pregnancies that already happened. 

kells621

To answer your question, my question was specifically why/how/in what way are stimulants unsafe to a growing baby?  "Not enough research" isn't the same as "no research at all". Re: your comment about my mind being dead set on continuing with the medication, I've been completely off Adderall since Wednesday. I'm still curious though. I'm not meaning to ask you in particular; if you don't have answers, that's fine, The question was just meant for other interested people. 

kells621

My college, at least, used to give students free access to medical journals online. So there is that way of finding them.  But honestly I usually just scan down the the discussion section. And go back through the article if  it seemed like the topic was relevant.  Am I claiming that I think that's always the best way to do it? No. In the article I mentioned that studied 2,000,000 pregnancies, they failed to give information about  the dose that the mothers were using, and that left me frustrated. Would I decide to advise people to take adderall based on what I read there? No. But I still think it has some valuable information that's one piece of a puzzle. I'm not a medical professional, and yes, my doctor has more information than me, you're right! I'm still interested in the topic at hand. I want to know more.  I never claimed to know more than my doctor. I utilize my doctor, but I figured these forums are just one more place to talk about things you're interested in...  I get the impression that my questions are being received as attacks, or maybe I'm just feeding trolls, I don't know, but they're just questions. 

kells621

I'm so sorry about your loss. I totally get wanting to take every precaution.  And I think it may seem like one is taking it for granted when there is an opportunity to *take advice to avoid* something (even if it's just because of lack of evidence rather than evidence of harm), but the person chooses to ignore the warning. Wishing you good luck.

meggyme

I think the problem is that you are asking questions that are better directed to a doctor. The people on this board are (generally) not medical researchers and even if they were, offering any info that could be misconstrued as medical advice would be unethical. There are many drugs for which there is not enough research to determine whether or not the drug hasn’t negative effects on a pregnancy.

Generally, it is for you and your doctors to decide if the potential risks outweigh the benefits for your personal medical history. We are not trolls, we are just not qualified to answer your question better than your doctor already has.

kells621

I get that. I think that's why I'm saying to people, if you don't feel like you have information, that's okay, then the question is for someone else.  Let me give you one example of how I'm using some of the feedback.  One of the messages I got in my inbox was about somebody who said their doctor mom has seen that a main problem with adderall is that it has to do with the mother's appetite, which leads to poor nutritional intake, which leads to low birth weight, etc. etc.  So next time I see my doctor, I can narrow one of my questions down to asking about birth weight. Some people have some leads offhand and they don't seem inconvenienced by shooting out an idea, so the question is just for them.  

kells621

Sorry I just wanted to clarify that by  "this comment is just for them", I don't mean other people aren't allowed to reply. I just meant that they don't have to feel obliged to reply.

kells621

On the note of doctors utilizing their access to medical journals, this is something I often think about.  Sometimes I think about calling the office ahead of time and telling them my question, so the doctor can research it before I get there.  There have been a couple of times that a couple of my doctors have looked questions up in front of me, and I appreciated that.  I wish they would do more of that; maybe that's the direction they're starting to head in.  I also can see how some might feel it would take time away from the patient and the rest of the appointment.  I just wouldn't expect a doctor to have all of the articles memorized. It would be cool if they started having patients send in questions ahead of time so they didn't have to feel pressure to remember an answer on the spot. I'd rather it be verified first.