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[How to advise an ADHD-patient about pregnancy? Exploring hospital psychiatrists' practices]
Background:
Currently, consensus on the use of medication for ADHD during pregnancy and lactation is lacking, complicating treatment decisions for fertile patients with ADHD.
Aim:
To describe approaches present in guidelines, literature, and local practices of hospital psychiatrists concerning counseling ADHD-patients on pregnancy.
Method:
From March to September 2024, a literature search was complemented by a questionnaire. Twelve hospital psychiatrists were questioned about how they advised patients with ADHD about pregnancy. We collected information on the use of medication, comorbidity, best practices and non-pharmacotherapeutic interventions.
Results:
Most hospital psychiatrists advised against stimulants during pregnancy. Alternatives were bupropion, non-medicinal interventions, antidepressants and antipsychotics. Most hospital psychiatrists advised against the use of stimulants or bupropion during lactation. Some hospitals used shared-decision making.
Conclusion:
The advice given to women with ADHD about pregnancy differs between psychiatrists. The description of their practices and considerations provided valuable insights for psychiatrists. Further research should follow on (non)medicinal alternatives for stimulants and the development of multidisciplinary guidelines.
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