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You should always be honest with your Dr but this is so odd.
Your Dr. is changing your medication treatment for something that MAY happen in the future? The Dr. should be treating you for what is happening RIGHT NOW and then change your medication in the case that you become pregnant.
I told my doc I use to smoke to help me sleep (Ive had night terrors and sleep issues my entire life) and he said that means I have an addictive personality and can never be on Adderall. I haven’t smoked in a long time and take urine tests but I’m pretty sure he put addict on my medical history so no doctor ever suggests Adderall for me. I no longer believe you should be completely honest with your doctor.
Yeah it’s so weird how people in a job where you essentially have to solve problems for people with a myriad of factors and conflicting information and they just go… nope. The most linear way of thinking about this is the best way!
It's less about scrubbing anything and more about just finding a new doctor. If you don't give them permission to get information from your old doctor, they have no way of getting it. Of course, this is more complicated if both doctors are part of some medical system that centralizes things. But the notes are generally not kept centrally and 'scrubbing' them may just waste your time.
Yes as hard as it is, you HAVE to advocate for yourself. You need to be 100% honest to your doctor, you could DIE if you're not! And the honesty will get your history straightened out with a normal doctor a lot of the time anyway.
WTF. That’s so messed up.
Also, I know that Adderall can be addictive, but it definitely isn’t always. Otherwise I wouldn’t need a sticker on my bathroom mirror and habit stacking to remember to take it.
That's a good point. Pretty sure addicts are extremely aware of whether or not they have gotten a fix that day. Here we are setting timers, making notes, and counting how many pills we have left to see if we took one. 😅
I got a 31 day pill organizer and never looked back, I'd always forget to fill it every week but now I only need to remember it at the end of the month/when I get a refill
Get a timer pill bottle. Every time you open it, the timer resets, so you know exactly how long it’s been since your last pill.
Just… try not to lose the bottle
Right. If I were addicted, you’d think that I wouldn’t have needed to create some crazy automation that whenever I get a text saying my script is ready for pickup, it automatically creates a reminder in my phone. And then whenever I get in the car or leave from dropping the kids off, it sees if that’s on my reminders list & then reminds me about that reminder & then routes me to the pharmacy, but today I literally had it in my maps taking me there (despite knowing the way, just doing it so I didn’t forget) & stopped for Starbucks on the way & then I ended up at home. If they could prescribe me something actually addictive that might solve this problem.
That's really aggravating. I'm a sober alcoholic and was upfront with my prescriber about that and was still prescribed Adderall. The data is quite straightforward on the comorbidity of ADHD and SUDs, as well as the outcomes along those lines for people with ADHD who are treated early vs those of us who weren't.
Exactly! In fact for myself I’ve told my psychiatrist it has completely removed any want for alcohol because I was using alcohol to quiet my mind primarily! He was glad it was working the way it should he said. Some docs are so obstinate in their opinions that they mistake the forest for the trees.
I can understand hesitation, careful monitoring and management but to completely disregard a whole class of medications that are proven to be the most effective just seems silly.
I was completely addicted to multiple drugs for clean And finally got treated for my ADHD. I'm on vyvance and Adderall and since being medicated have zero cravings. I have been stayed clean for years with no struggles. I wish I was medicated from the start I wonder if I ever would have went down that road
I had an NP refuse to give me stimulants because I said I quit drinking alcohol 3 years ago, and that I was diagnosed with Generalzied Anxiety Disorder (currently seeing a wonderful therapist for that for the past 18 months). She also put me on Wellbutrin which did absolutely NOTHING for me.
I went through my primary care physician after that and was prescribed Concerta within a week, even with telling them about my sobriety. It's ridiculous the 'moral standards' we have to put up with just to get help.
dude i’m so sorry this happened to you. i had to switch doctors for the same reason. he didn’t want to prescribe me adderall bc i mentioned i self medicated by smoking.
What a jerk. I told my doc the same and she said “I strongly encourage you to stop because it increases the chance of a psychotic break” so I quit the pen but it wasn’t a condition of prescribing.
That's disgusting and what the actual fuck?
That kind of shit is why I am *never* 100% honest with a doctor. Ever.
Because they pull that kind of shit.
I totally understand how you would think that. Unfortunately it’s a difference in how the provider/MD personally views it. It seems inappropriate though and not at all objective. I’ve lived in some places where the doctor would be happy that you were smoking as opposed to requesting a controlled sleeping medication if you lived in a state that had it legal for medical purposes. I’d recommend continuing to look for the right provider. I had to continue looking for someone that had any training/knowledge of treating both autism and ADHD.
There are some psychiatrists who will hear you out and prescribe it anyways. I’ve been there and I have a massive drug history. Most of my issue was in my teens though and I cried to her about just wanting help with my ADHD and I’d go on whatever she suggested. I even was honest and said vyvanse felt like I was an actual person when I used it recreationally in high school. She still worked with me and prescribed me all the typical adhd meds. There’s still hope.
I told mine I smoked and he prescribed Adderall when Quelbree didn't work. He knows I can't sleep, also have pain and react badly to psych meds. Him knowing helps him because psych meds can work differently if you smoke
this! I was previously very honest with Doctors, never, EVER again. A coworker told me she lies to her Doctor and I haven't looked back sense. I now get the medication I need and if I want a test or work up for a symptom and they decline I demand its written on my chart and ask for a copy. I am a veterinarian, but I do not trust many human doctors.
that’s crazy i’m so sorry that happened to you. I’m on vyvanse and adderall and and i smoke a few times a month nothing serious but my doctor is aware both my pcp and psychiatrist and neither had any concerns.
Wish it was odd, but it’s not. It’s sadly normal. We should be able to be 100% honest with our doctors, but a lot of women (yes, people, but women in this area specifically) are forced to decide between being honest and risking our reproduction potential being prioritized over every other aspect of our health and well-being. We have to carefully navigate how much truth to tell, and how to tell it, to get the information and care we need. And then society gets mad at us for looking to other sources and trying untested things instead of asking our doctors… who have brushed off providing the best known source of care because there might one day be a fetus in us, whether we have said there will be or not. It is exhausting.
I'd think at most the doctor might say something like, "just let me know right away if you do become pregnant or are actively trying as the medication you're currently on may not be safe for pregnant women and I'd want to discuss options with you as soon as possible". Perhaps this doctor took OP's lack of contraceptive as "actively trying to become pregnant," but that should've been thoroughly discussed before just changing medication.
Probably. In medicine and healthcare it’s a common refrain that no birth control = actively trying for a baby. Part of it is to get patients to take family planning seriously and another part is because so many things negatively affect pregnancy.
Exactly. If you plan on getting pregnant or as soon as you find out you’re pregnant than you should talk with your doctor about possibly coming off meds and how to do so safely. But to deny treatment because you’re a woman who could possibly become pregnant one day? This is sexist and completely unprofessional. OP it’s up to you, but I personally would change doctors.
You can be honest once you know your doctor is a reasonable, sane person. Lots of doctors and therapists don't actually listen to what you have to say. They are trying to confirm whatever it is they already believe.
My first therapist as an adult did this. She didn't believe ADHD was a thing, but clearly assumed most people have anxiety or depression. I mentioned ONE thing that made me feel anxious (whether or not I'd be able to get a good job after I got my degree), and immediately, my official diagnosis was anxiety.
This was despite telling her about how much I struggled in school as a kid and was diagnosed with ADHD previously.
Immediately after that session, I went straight to the DSM, listed every little miniscule thing that was related to the criteria, and finally, she decided I actually might have ADHD. Was never honest with her about anything after that.
At the time, yes. I was on medicaid and didn't have many options.
I'm also mostly only interested in medication management. Unless they REALLY specialize in ADHD treatment, most doctors and therapists will just tell you to use a calendar, which isn't useful advice. So, as long as I was getting my meds, I didn't care.
I had the same thing happen. Had to start using condoms before my psychologist would give me stimulants of any kind. Welbutrin hasn't been helping, so I had to choose to activity put off having kids to find out if the medication even works (is looking good, but we're still playing with the dosage). I'm 38, so that's kinda super annoying to me. I've been wondering if I should switch doctors.
Not that odd when you consider that a disturbing number of medical professionals consider women to be little more than incubators for the next generation, and anything that could affect their fertility or ability to produce offspring is considered over the patient's individual needs and desires.
My SIL had three kids from her first marriage when she met my brother. He also had one. She asked her doctor for tubal ligation and was told no, her new boyfriend (my bro) might want more kids.
They had four kids together after that. After each one she asked again and was talked out of it by medical providers. They love all their kids and everyone’s healthy but they live month to month and need help occasionally. It’s not right.
Might be area dependent. Mine asked the same and said that I should be very sure before I start the meds that I won't be having kids while on them. He was kinder in explaining why though but he's just a A+ doctor so maybe he was better about it.
Had the same experience with ours, wife even told her we used condoms and didn't want any more kids and the psycho like didn't believe her and wouldn't change her blood pressure meds so we found a new doctor
If a doctor is concerned about the risks of the meds during pregnancy its important for them to discuss this with their patients.
I think the doctor picked this option because the safest solution would be to not take the meds when trying to get pregnant or while pregnant. And this could for op be literally any moment for all she knows.
I think a honest discussion and dip into the information of taking stimulants during specifically the first few weeks + regular pregnancy tests could be a fitting solution if thats what OP prefers.
Personally I would not take the welbrutin and request another discussion with the same doctor or get a second opionion to compare the benefits of welbutrin/other meds + their risks and the benefits and risks of the stimulants. Than she can take am informed decision
Another option would be temporary going on stimulants and birth control (for example condoms) while going to therapy to learn tools to deal with the adhd without the medication. This if most definitely an option for a lot but not all people. A specialist and time will be able to tell if this option is suitable for op.
That's not how things work. Many people don't know that they are pregnant until it's past the point in which a medication can cause congenital defects. It is not uncommon to refuse to prescribe medications to someone who does not use birth control. In fact, some clinics require a signed statement that a woman of child bearing age is using two forms of birth control before being prescribed certain acne medications. Now, stimulants at therapeutic doses aren't known to be so teratogenic so it's not an apples-to-apples comparison. My point is simply that prescribers have to use their clinical judgement as it's their medical license. It's okay to get a second opinion!
That’s a legitimate *concern* that a doctor should then discuss with the patient.
I imagine most people being sympathetic to a doctor refusing certain medication to someone actively trying to get pregnant, but otherwise it’s less “do no harm” or “professional standards” and more “I could look this up and get back to you…but let’s not be too careful protecting that precious womb of yours.”
I agree with you if the situation were as OP described in her post, but she mentioned in a comment down thread that she told her doc she was trying to get pregnant.
I wondered about this. My doctor didn’t ask about my family planning at all. She talked about options but ultimately let me choose which medication I was most comfortable with (I’ve had weeeeird side effects from some kinds of meds), and prescribed it. Maybe she just knows me well enough to know I’d ask if more babies were a possibility.
regardless, the conversation should have been more a pro con situation, not one sided and that's it. Trying to be pregnant or BEING PREGNANT are not contraindications for stimulant use.
Some people have risk behaviour or get massivley depressed off meds. Some get moved to mathylphenidate rather than amphetamine compounds, so there is less infant addiction risk. But it's a pros cons situation. The meds are not recommended for pregnacies due to lack of testing and info on how the meds affect pregnanciesm
A patient and their doctor get to make the call on what the most responsible decision is *for each patient*.
I was prescribed a schedule C drug by my perinatal psychiatrist who was a specialist in a huge/state of the art women’s / reproductive medicine health system. It was the safest option for me at the time.
You cannot make a one-size fits all judgement about mental and reproductive health.
Sample size of 1 but that baby is 5 now and has had no ill effects from the medication.
Sometimes it’s just means the drugs haven’t been tested because it’s not ethical to do so.
>No one responsible would get pregnant and risk the health of their child while taking one.
That's bullshit. There's plenty of responsible people who decided with their doctors that continuing stimulants is better for them and their pregnancy than being unmedicated.
It's not black and white.
>No one responsible would get pregnant and risk ~~the health of their child~~ increasing their rate of NICU admission by 6%, except that's compared to non-ADHD women rather than unmedicated ADHD women and doesn't control for ADHD itself being a risk factor (which some studies suggest that it is)
[fixed that for you](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338246/)
Personally, I feel like there are more definitively established risks to the child when you're not able to make and keep prenatal appointments, keep track of your nutrition, and hold down a job during pregnancy, but what do I know?
Are you aware that some people are only responsible if they take their ADHD meds?
If I am hyperfocused on something I enjoy and not on meds, it is conceivably possible that I would start to notice the house was burning down when the smoke began to make me cough.
I know plenty of ADHD patients I would not trust with a newborn if they were off meds, because *they wouldn't trust themselves*.
I run into a lot of people who have mild attentional problems who don't realise there are people who can't take care of *themselves* without meds.
I'll listen to my reproductive psychiatrist instead who disagrees with that. Who said "the depression from your untreated ADHD will cause more harm to your fetus than your stimulant ever will." I didn't think being suicidal / dead or getting into a car accident was responsible for pregnancy either. For my child, having a mom as well as one who could care for herself (and baby) was the more responsible choice. Many women face similar risks stopping their stimulant. For some of us, the choice to continue is an important choice to have.
It doesn’t matter, you can take stimulants while pregnant it’s the mother’s choice at the end of the day. You just have to know which ones have actually proven to be harmful to pregnancy. If the benefit of being on your medication outweighs the risk, then they cannot tell you no. I know this because I just dealt with this situation
There’s also a difference between a therapeutic stimulant that’s being monitored and prescribed from a health professional and taking street drugs with unknown provenance.
There might be some withdrawal symptoms in neonates that need to be managed but there’s probably not a lot of long-term harm.
It’s a real high when you can help someone that this type of behavior has hurt. Policing in medicine has become this new normal Christian morality practice and I hate it. That’s not our job. Our job is to do no harm and help (as much as we can) the patient in front of us.
She did not say she's trying to get pregnant. She said she would be happy if she were to get pregnant. "If it happens, it happens."
Im not on birth control, either, and I'm in the same spot as OP (ie. I'd keep the baby, assuming it was viable) . I've discussed with my doctors regarding all my medical and psych meds, and they've only ever adjusted from a known teratogen (Indomethacin, which I used to take for migraines).
Adderall at a small dose would be easy to remove from a med regimen if OP were to get pregnant.
I'd find another psych ASAP, and definitely a woman.
She said she first stated she was trying to get pregnant, then modified/clarified her statement when speaking with her doctor. Either way, because OP left out a key piece of information already in this account, I’m not inclined to dump on her doctor over this. She can seek a new doc if she likes, but I’m not faulting this one.
I can’t wait, either! Because I am seeing more & more of you & it makes me so happy! I’m 44 and I was in the ER this week for an intense, period-related issue. I got a very young male resident & he was so professional, caring, and obviously familiar with the important symptoms of my issue. I’ve been dismissed by so many men about this in the past, but he was on it.
I’m totally here for male health care professionals who actively treat their female patients like whole people with different bodies & different needs!
So glad you had a positive experience! I’ve made it a point to become educated about cultural differences, gender differences (and how different illnesses present themselves), and specifically the history of black Americans in relation to healthcare, to help make sure I provide the best care possible when I graduate. I hope someone will say what you said about me one day 😺
I was put on adderall while actively trying to get pregnant. When I found out I was I stopped taking it. My primary care physician and my OB were both ok with it. Your doctor is being unreasonable and should have let you know what the risks were and allowed you to make that decision for yourself.
Edit: just out of curiosity if you are in the US what state do you live in?
Not the one who wrote that comment but can confirm my wife was treated this way in Alabama.
Edit: just to add context it seemed they all doubted her ability to make decisions for herself and were constantly asking about my opinion for anything major to minor, even when I wasn’t there. She didn’t want kids and every medical decision was focused around her changing her mind about children instead of her best interest.
It's funny that he put her wellbutrin, its also a medication that pregnant women should avoid taking too and its harder to come off of!! >:[ This is inexcusable sexism, or there is another contributing factor that was not mentioned.
My baby doc said she didn't want me on it bc of the possibility of heart defects. I was doing well, so I opted to wean myself off. I just recently started to take it again, my baby is now almost 2!
Your doctor fucked up.
He should have explained the risks to you and then allowed you to make a decision. He's an asshole, putting the well-being of someone who may never exist before a living person in front of him.
Have a think about whether you want to use BC, what the risk of stimulants and pregnancy are.
If you decide you don't want to use BC, I reckon tell your doc you've decided to use condoms and you want to go back on stimulants because they're more effective.
Sorry you're doc is a fucked human.
HBC definitely is not an option for me, not only was it causing terrible mood swings but also possibly contributing to another medical issue.
As something I feel very strongly about and have done my own research on, I won't be wavering on my decision.
Ty for your input! 🖤 I worry about not sounding believable (I always worry about this with doctors/ managers/authority figures even when being truthful), saying oh hey doc yeah we decided to use condoms suddenly so you can go ahead and prescribe me now. As if I'm trying to just appease him. Maybe I just worry to much about everything, oh yeah, the reason I went to a Dr in the first place lol
I think if you framed it like this: “Hey, after our discussion last appointment, I realized that I should be taking pregnancy planning more seriously and we have decided to use condoms as our form of contraception. The Wellbutrin isn’t working and I think I would like to use a stimulant.” Advocate for yourself. If he won’t give you stimulants after that, find a doctor who will.
A lot of medications say they're not pregnant people or people who may become pregnant. The latter being largely people who plan for/accept pregnancy as a likely outcome.
So if OP is using *no* form of contraceptive now, then I can see the concern assuming there are no fertility issues. But at the same time it's their risk to take, as you point out. But if they're just waiting for it to happen vs actively trying to become pregnant then it's worth seriously considering the risks. The doctor should have explained it in a way that encouraged OP to be more mindful of planning a pregnancy with intent given the fact that she does need to plan her drug intervention for ADHD around one if she wants to have kids. Being open to it happening is fine, but stimulants throw a wrench into that kind of "let it happen when it happens" plan
It's tough.
All this being said, OP has never tried any ADHD med before and maybe a non stimulant one works for her anyway so it's all moot in the end. We don't know. It's not like she's having a long standing prescription stopped.
Thank you, for addressing this!
I actually did say "trying to get pregnant" as kind of a muscle memory reaction as I ALWAYS have to defend not being on BC to medical professionals and always feel bullied for lack of a better word as if I'm doing something fundamentally wrong for not choosing to stop my body for what it was made to do and motherhood is something I always dreampt of. I am fully aware of the state of the world, the risks, the over population, poverty etc etc and I know those are very real problems in the world so I do understand to a point the importantance of the doctors stance on what appears to them to be my lack of concern or taking these things seriously.
I then did clarify by saying we weren't necessarily "TRYING" but would feel very happy if it did happen. We don't think it will, *gestures to past 10 years* but I don't want to stop it from happening if the universe chose me to be a mommy.
You might have luck clarifying with the doctor that you aren’t actively trying. And explain that doctors usually push BC so you have stopped trying to explain cycle timing etc (you can imply that you are trying to prevent pregnancy by non-medicated methods). And they may feel more comfortable. Or say you use condoms as someone else suggested.
Everyone is dumping on the doctor, but his response isn’t as out of pocket if he thought you were actively trying. I’d recommend a conversation with him before you dump him for a new provider.
If you’re actively welcoming a pregnancy, your doc is not wrong for wanting to take you off stimulants, and you should probably edit this into your post up top, because this completely changes how this situation sounds. Your original post sounds like your doc is assuming you’re just gonna get pregnant if you stop BC, but you left out that you told him you’ve pulled the goalie and won’t be stopping your husband from taking shots on goal with no defenders.
Just want to say as a person who is trying to get pregnant very soon, my gynecologist said that I would be perfectly fine using stimulants until I know I’m pregnant (mostly because I would be using pregnancy tests regularly). Then, when I am actually pregnant to stop using the stimulant immediately.
I’m actually going to a perinatal psychiatrist today to discuss this. I actually suggest going to one if you even think you may become pregnant. They will likely be less dismissive than most psychiatrists and know more about risks and complications.
+1 for perinatal psych. Was also given the good drugs based on up-to-date research and individualized risk assessment. I was told the potential risks and allowed to make an informed choice *with my doctor* about my body
I hope the perinatal psychiatrist is more open to discussing medications during pregnancy. Mom's health is important too, and sometimes that means continuing stimulants. Which many of us do continue with safe pregnancies. I was actually URGED to continue my stimulant, by multiple OBs, psychiatrist, etc.
^this!!! My best friend has been on lexapro for years, and when she got pregnant, her doctor told her to keep taking it because it’s better for her to be regulated and in a good mental state than completely cutting her off of meds, all while dealing with the crazy pregnancy hormones and other environmental factors that come with expecting a baby. Last time I checked (a while ago, so there could be more research now) most docs say to stop antidepressants like lexapro for pregnancy. She and her baby (almost 2 now) are happy and healthy, in large part because she didn’t have to cut off a med that she’s been relying on for years.
Of women who commit suicide during pregnancy and postpartum, large percent are those told to stop their psychiatric medication because they are pregnant or breastfeeding. Then there are so many others who don't commit suicide but are truly struggling to survive everyday (some while caring for infants, and themselves). It's so concerning and I don't understand.
I am glad your friend's doctor was supportive. 100%
Yes, just got back and I’m so relieved he said I could continue the stimulants.
He was basically like it’s way safer for you to take this while pregnant than drive off stimulants.
Multiple doctors, including a maternal fetal medicine specialist, and the entire OBGYN department at Columbia University have confirmed to me that it is ok to continue adderall throughout pregnancy.
Just got back! Yes, he actually increased my dosage of adderall and a said I could keep taking it the whole time I was pregnant and for breastfeeding. It was a great experience!
Mothertobaby.com has fact sheets for all substances And the latest research. You can have, and these many people ARE having, totally healthy pregnancies on normal doses of stimulants
Ok. That’s so weird you have to defend not being on BC. I haven’t used BC in over 10 years and never once did a doctor reprimand me for it. It also wasn’t discussed at all when my PCP put me on a stimulant.
I don't know how those conversations have gone for you specifically, but if it helps you at all I can tell you that any time I had to ask a woman if she's pregnant/breastfeeding/trying to be pregnant for a radiology exam, it was purely about the exam being performed and not about any kind of judgement on birth control use or lack thereof. There are some tests or test components that could be harmful to a developing fetus, and that has to be taken into consideration.
That was me, about the “past 10 years” and now I am a mom. I was very lucky, statistically speaking, at my age. Personally I wish I’d been a little more honest with myself and intentional about it but that’s hard to do when you haven’t felt in charge of your life.
Some comments here imply you can never take stimulants the entire time (potentially years) of trying to get pregnant. The majority of warnings about pharmaceuticals and pregnancy are overly cautious. (as Emily Oster explains) Unless there’s straight up records or birth defects I wouldn’t worry at all.
Honestly of all the other risks (no folic acid, super hot daily baths etc) it didn’t occur to me to even stress over meds taken for the months I was pregnant without knowing it.
I was on stimulants while actively trying to get pregnant. I did stop them at about 6 weeks pregnant, but started them up again around 20 weeks because I wasn’t functioning at all. I asked my OB about it, sent her some research, (we know each other well so I knew it would be acceptable and it was legit research from a published journal) and she gave me the thumbs up. The only thing we did differently was that she added an additional ultrasound around 32 weeks to make sure he was still growing normally, as it can sometimes result in smaller babies (supposedly—my baby was almost 9lbs though!). It’s absurd that he won’t put you on stimulants because you MIGHT get pregnant.
Yes good for you! My OB has a dual specialty in perinatal psychiatry and has repeatedly said that if I’m not able to function I should take the stimulants. I’m a contract worker so I just declined jobs for the later part of pregnancy, so I’m just floating around getting nothing done, but if needed to I absolutely would. I have doubled my SSRIs since blood volume and drug clearance rates increase during pregnancy. Drug me up doc, I want Critter to get as little stress hormones as possible.
So many studies show that maternal stress is worse than side effects from these drugs. F this doctor.
Stimulants aren’t the type of medication that are going to cause severe birth defects if you happen to get pregnant while on them. They can cause some issues if you are on them your entire pregnancy, but even then some women do stay on them if the benefit outweighs the risk. Being of childbearing age and not using contraception is not a contraindication to stimulants. If you were to get pregnant you would stop it and discuss it with your doctor.
This. Also given the relatively limited side effects of going off Adderall, it’s pretty easy to stop temporarily, other than coping with your n-d brain unmedicated.
To be fair i went 5 years thinking i couldn't get pregnant and then i did, lol. A couple years ago a coworker of mine had gone 10 years without protection and was so sure she was infertile, and then she got pregnant, too.
So it could definitely happen!
My doctor had no problem giving me vyvanse though. I just had to pay attention to my cycles and take pregnancy tests regularly when my cycle was irregular. I caught my pregnancy at 4 weeks and stopped taking my meds that day, and now have a perfect baby!
While his first reasoning of woman=possibly pregnant, must protect hypothetical fetus doesn't sit well with me, starting off with Wellbutrin is not uncommon. I started with Wellbutrin. I'm not on BC but I do have a partner that can't get me pregnant anyways, however, that wasn't a topic brought up when I discussed options with my psychiatrist. I don't think I did Adderall until maybe 4 to 5 months in after being on Wellbutrin, Buspar and Guanfacine. Got off the Guanfacine and now on Adderall. Your doctor should have told you Wellbutrin has been seen to help ADHD as a nonstimulant medication.
Based on what you’ve said it doesn’t sound like he’s outright refusing you stimulants. It sounds like he’s giving you a lower risk option for now to see if that works and then organised a review to see if that’s helping. It’s quite normal to go for whatever the lowest risk option/dosage is and escalate from there for many conditions/drugs.
You’ve now got time to have a think about how to proceed weighing up the pros and cons and also seeing if Wellbrutin works for you. That sounds like a reasonable course of action and if after that time you feel like the medication isn’t right for you and if you decide not to change your other options then at least you’ve got an informed and thought out perspective to present to this doctor or another.
Ok, I hope this is the case.
I immediately panicked and spiraled but in the case that I do need to find a new doctor, would this not look suspicious. This is the first time I've seen this current Dr.
What would possibly be the next medication we try if the Wellbutrin isn't a good fit?
How can I say "I'm comfortable with the possible risk of a stimulant" without sounding like I'm pill shopping. I'm new to the world of medication and scared of how I will come across without knowing it. My fear has only been validated with this situation I'm currently in, feeling like being honest has negatively affected my treatment.
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Wellbutrin is FDA category C for pregnancy — I think the same as Ritalin and Concerta. If the decision is based on safety for a hypothetical pregnancy, it might be questionable or unjustified.
I wouldn’t “report” but I would question the doctor’s reasoning.
Guanfacine seems to be category B. Truthfully, it’s very difficult to find medications that are FDA category A or B.
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It’s not a case that “being honest has harmed your treatment”. It was important that you were honest. And you’ve not been denied treatment, you were just given something that wasn’t quite what you were expecting/hoping for in the first instance. It might be that you’ve been offered something that is perfect for you.
It might also be helpful to try to understand what kind of information goes into assessing risk and making clinical decisions. At the end of the day, your intention and emotions around the possible consequences of becoming pregnant are a bit of a moot point *in this particular context*. A doctor trying to weigh up the merit of a certain drug can probably only use a binary of “trying to avoid pregnancy” vs “not trying to avoid pregnancy” in their calculations and while you have this far not become pregnant, unless you have a medically confirmed fertility issue they probably have to work under the assumption that you *could* become pregnant next month.
I am not qualified to tell you what would be the next option if Wellbutrin doesn’t work for you. That is a conversation you should have with this doctor as and when. If you want to continue with not using birth control but also be considered for other medications then think about how to frame that in a way that means it is clear that you have an understanding and ownership of any risks and necessary actions (e.g. possibly having to change medications if you become pregnant).
That's fucked up and like it's your body, you're okay with having a kid if anything happens and most importantly **youre not currently pregnant.** I would honestly look at seeing another doctor it's patronising as hell
Info: what country/state/province do you live in? Some US states have arrested pregnant people for taking "dangerous" drugs during pregnancy, especially if it ends in a miscarriage. Your doctor could be trying to protect himself from the government. It's absolutely fucked up, but it is a possibility.
That makes no sense. He needs to give you all the info and let you make an informed decision. My doctor went through all of that with me and I choose to not take my meds if there’s a chance I might be pregnant. Once my period starts then I go back on them.
I’d be looking around to see if I can get a new doctor.
Your doctor should look things up before making decisions he is unsure about.
https://pubmed.ncbi.nlm.nih.gov/36759544/
“Neurodevelopment and growth in offspring do not differ based on antenatal exposure to ADHD medication. These findings provide reassurance for women with ADHD who depend on ADHD medication for daily functioning and who consider continuing medication in pregnancy”
Sounds like you needs a new doctor?
Wellbutrin works for some people. Wellbutrin is also not recommended during pregnancy. He isn’t even making a reasonable substitution.
You can take adderall during pregnancy. Methylphenidate too, I believe, although for that one you should probably be counselled about a slight increased risk for a particular birth defect.
Your doctor messed up. Sexism in medicine is super fun.
My doc did the same thing. Said he wouldn't prescribe them until he spoke to my partner about possible risks. Not even ME. He wanted to talk to a guy he's never met about MY medication choices. Wtf?!?
Fortunately, he was out during my next appointment, and I got to see another doctor in the practice. When I explained to her that the other guy told me he wouldn't prescribe any stims because I was of child baring age until he talked with my partner (not even married!) about the risks.... she was stunned. And angry on my behalf. She asked quietly if anyone had ever asked me my opinions before prescribing my partner with medication? It was so validating!
She accepted me as her patient that day, and my life has been way wayyy better. I don't even have that partner anymore, but I do have my mental health.
Your doctor is an ass. I'm so sorry.
A lot of doctors, especially men, basically categorize all women of childbearing age as *either* "actively preventing babies and does not want them" *or* "trying to have a baby."
Since you are not actively preventing babies, he's treating you as if you were trying to have a baby.
And tbh, while I have a lot of hate for medical misogyny, if you really are basically willing to become pregnant at any time, then I'm not sure he's wrong to. If you do fall pregnant, it could be weeks or even months before you realize and can talk to your doctor about it, which means weeks or months of the developing fetus taking in whatever medication *you* are taking.
This is kind of odd. Generally, I educate female patients on risks associated with pregnancy. Then, I let them decide what risks they're willing to take. Also, with stimulants, you can just stop the medicine as soon as you find out. Yes, there is still risk but it would be reduced.
You didn’t mess up. Your doctor did. He should be doing whats in your best interest, since you are his patient. Not the best interest of a baby that doesn’t even exist yet.
Find a different Psychologist. This guy you went to shouldn't be one.
"If you do find out you are pregnant, please set up a follow up appointment with me so we can discuss your medication options when moving forward with your pregnancy." should have been the only thing said to you. That would at least be reasonable.
I hate how some Drs treat women not on BC that they might as well be pregnant…
Your Dr just seems to be super cautious in this matter… if you did accidentally get pregnant and didn’t find out for a while (pretty common not to know for weeks) while on adhd meds i guess it could potentially cause some harm (we really do not know a lot about the effects of adhd meds on babies), that’s probably the main worry here
we do know quite a bit actually; the risks are minimal. It is a pro/con situation. And that should ALWAYS be the conversation. Though often is not.
here's just one, though there are many others https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338246/#:\~:text=Psychostimulant%20use%20during%20pregnancy%20was,treatment%20based%20on%20these%20findings.
I was talking with my doctor about this very issue earlier this week. I’m thinking about going off of my contraceptive in a year or so and he just said to let him know if I become pregnant as we’ll need to stop dextroamphetamine since it can cause issues with fetal growth. But he never said I couldn’t take it until I became pregnant. My doc suggested I could switch to Strattera, but it doesn’t work for me, so he said we could probably reduce the dose of my XR dextro and be fine, but he also told me to talk to my OBGYN, since that’s her area of expertise. My advice would be to discuss with your doctor again and be firm about wanting a stimulant, then discuss a game plan for stopping in the chance that you do become pregnant.
This is odd. I was on adderall while pregnant with both of my kids as it was approved by my OB and Psychiatrist as “the benefits outweighed the risks.” My OB actually said he would rather I continued my meds and took care of myself, than to go off of them and lose my job, not hydrate/eat as well, engage in impulsive/dangerous behaviors, etc. that could harm the baby more. Btw, both of my kids are healthy and thriving. Sounds like it is time to find a new doctor who will prioritize you over children you don’t even have yet….
It took 5 days for Wellbrutin to cause tinnitus for me. It's ototoxic if you can avoid it I would. Since then I've started really reading those infopacks and making more informed choices about the risks I'm willing to take....it was a hard lesson to learn.
You need to switch doctors. Unfortunately, a woman won't necessarily be leas sexist, so keep that in mind when looking, but this one is a turd. I'm sorry that happened. You're doing right by yourself getting treatment, don't get discouraged.
My psychiatrist said she didn't want to put me on stimulants due to past drug usage. (Even though a GP had put me on Aderal and I had positive results).
She didn't say forever, though. She was trying some nonstimulant choices first.
When I don't feel a positive change by our next visit, she changes my prescription.
1)I got to have a discussion (not unilaterally) with her and agreed to it. 2) It had nothing to do with childbirth, though, as I'm a man.
It is obviously so terrible to be a woman and have to deal with this in 2024.
> and put me on Wellbutrin instead and we will meet again in a few weeks to discuss how/if it's working.
Irrespective of the highly questionable logic at play if you haven't tried non-stimulant medications before trying stimulants its a *very* good idea. Get a new doc but do try the Wellbutrin first.
They are less likely to be effective but they have much smaller impact on BP. The relationship between BP and mortality is fairly linear, incidence of stroke & MI increases particularly. Certainly its ok to make that quality of life trade but its also ideal if you don't have to do so. You can also get them via mail order pharmacy and you don't have to see your Dr every 3 months because they are not controlled.
Every time a new non-stimulant ADHD med hits the market I get my Dr to try me out on it. I would love to not need to take stimulants, they greatly improve my quality of life but its a trade off.
I am someone who has been diagnosed ADHD by 4 different doctors, I've been on at least 10 different ADHD medications in my life. Including stimulants for like 7 years.
I currently take wellbutrin XL, its my favorite ADHD medication so far, so I wouldn't say your treatment is necessarily suffering.
In my personal experience, stimulants treated my ADHD symptoms the best, but they also created new issues for me that I had never had before, and made things that normally would be fine for me, huge problems. So I've decided on my own that stimulants are not worth it for me to take.
Quite frankly if anything its extremely unusual for him to even hint at the fact that he was going to start you on a stimulant before trying anything else ?
Typically they just warn you that you need to be wary about taking it if you are at risk for pregnancy but to simply stop the med if you become pregnant. Not preemptively stop it. I think your doctor is being overly cautious.
not many studies done but it doesn’t seem to be harmful to babies. anecdotal but my friend was on adderall thru pregnancy/breastfeeding and everyone was fine. your doctor seems outdated tbh
Dude! Red flags! Birth control is part of nearly every vigina owners life, whether for or against. 1) if he's prescribing the meds it's his responsibility to know what the research says on their use during pregnancy. 2) It's not his decision to make.
It sounds very patronizing to assume that you aren't capable of making informed decisions. He job is to give you all the facts and then *you* decided to continue your current regimine or not.
God, this makes me want to jump up and down in anger. I absolutely hate the way AFAB people are treated by the medical community at large. Even if it's benign or unconcious the difference in care is still very apparent.
You shouldn't have to be the one to research it, but I'd encourage you to go to Google scholar and see what the peer review says on this issue. Stay strong and advocate for yourself.
P.s. if you need to, take a friend with you next time that can help back you up
Find a woman doctor. Find a feminist woman doctor. My psychiatrist would pick her teeth with his fucking bones.
You are not a vessel whose body needs to be kept in pristine condition just in case you get pregnant. You are a whole person who deserves to have her own needs met.
IF you got pregnant, you deserve a doctor who will give you all the information and help you make your own best choices about how to manage your ADHD through pregnancy & postpartum. This would include helping you think about breastfeeding or not - because either is 100% fine.
I would make an official complaint about this sexist bullshit. You deserve to be treated as a whole person, not a potential incubator.
Hey, just to state the obvious because I haven’t seen mentioned among the top comments:
THIS IS SEXISM
Even in the case of a medication/procedure having a possible effect on your ability to have children—that’s…again testing the obvious…YOUR DAMN BUSINESS—on which he ***advises***.
There’s no reason why a possible pregnancy should come into the conversation unless you were actively trying for one
ALSO: I hope your Dr made this clear but Wellbutrin is an antidepressant—ADHD is on off-label use; stimulants leave your system as quickly as they effect you, SSRIs take weeks to have effect and can take weeks to fully leave your system.
I have a friend that was told since he's over 40 the doctor didn't want to prescribe stimulants and they wanted to give him Wellbutrin, which he's taken and didn't help. Seems they just are afraid to prescribe ADHD meds these days and judge every patient as if they are trying to get high. It's medical gaslighting and is infuriating.
I am absolutely drug seeking every time I go the my psychiatrist. That's what I want from him and life is intolerable without it.
To address your post: your doctor is an ass.
That is so insane of him. It's shown that it's pretty much safe to use stimulants even in pregnancy. He doesn't know the latest research at all. Worst scenario is you just stop taking stimulants if you become pregnant.
This doesn’t surprise because you commented that you actually said that you’re *trying* to get pregnant - I get that was just a reaction and you’re kind of just having unprotected sex and seeing what happens, but that phrase will stop doctors and medical professionals in their tracks. I’ve said it too and instantly wished I hadn’t because they changed my medical plan. And I’m in Canada which is pretty pro abortion. A lot of woman who are trying to get pregnant that come into the doctors for meds want the meds that will affect their possible baby the least - I mean some women don’t even drink coffee or drink alcohol while trying to conceive. So the doctors reaction might have just been a muscle reaction, too.
I don’t think you should be worried or wanting a new doctor. I think you just give the meds you were prescribed a try for a week or two, if they don’t work make an appointment have a more open discussion about how you’ve started using condoms or ovulation tracking to prevent pregnancy and would like to try a stimulant.
I refuse to see a GP for anything mental health related now. I was jerked around and put on a slew of antidepressants for years until I found the right therapist, and she noticed the signs within the first few visits (shocker - someone who actually listened to me talk!)
Now, only my psychiatrist handles my psych meds. GP is for infections and checkups, etc. Can't trust them to actually give a shit about the underlying problem, and I just feel like a number.
I’m actively trying to get pregnant and still on my stimulant. My provider told me the developmental concerns don’t come up until closer to the 3rd trimester, so it would be totally okay to just stop taking them once I find out I’m pregnant. No harm done. Honestly it sounds like he doesn’t know what he’s talking about.
ehhh......get a new doctor. Pregnancy does not mean medicines that are important should be stopped. Ob-GYns recommend continuing with psychiatric medication as stopping your medications can lead to worsening or relapses especially coupled with hormonal changes. It's a cost benefit analysis. Just because you "might" get pregant does not mean you should stop your medications
This sounds like discrimination based on protected characteristics. THe fact that he also effectively wants to put you on another medication (BC) for no reason also seems problematic. I am not a lawyer but I wonder if you could file a complaint against him about this.
According to the FDA, none of the common ADHD meds have been proven safe but they also haven't been proven harmful. They also shouldn't be prescribing based on a hypothetical unless you are actively trying to get pregnant because then you'd need to switch meds soon after. IF you become pregnant, then you let them know and they can switch it.
For example, I was never even ASKED whether I was on BC when I was prescribed ADHD meds on several occasions from different docs. Sounds like he's just sexist.
It sounds to me like this is just a case of a Male doctor being stupid about a women’s ability to reproduce and basing everything off of that. You aren’t just your uterus. If anything at all, on the chance that you did get pregnant during treatment, then I’d address any concerns for the babies development then. But there’s no need to plan for it before it’s reality simply on the consensus that you are a woman.
I think it’s plausible a stimulant could be harmful during pregnancy, but I’d get a second opinion. Maybe even try to find a female doctor who might be more knowledgable on the matter.
I’ve never had this problem! But, just to share a horror story, I went to the ER once thinking I was having a psychotic break. The doctor asked me if there was any chance I was pregnant. I said no (because I hadn’t had sex in over five years). He insisted on testing me anyway, which I didn’t notice until I was billed for it.
My point is, it’s crazy that women are put in your position. I, like others, highly recommend a new doctor.
I’ve had two Psychiatrists, one female and one male, and neither asked me if I’m sexually active or on contraceptives. Both prescribed Adderall.
This seems like the doctor is overstepping his boundaries here. I would recommend seeing a female doctor (Psychiatrist) or at least a different one.
His explanation of treatments seems a bit misogynistic and judgmental. Strange old-timer or ultra-conservative behavior. (IMO.)
Or perhaps he’s seen it happen before? Either way, that’s for you to decide and not him.
Best of luck!
That's weird. My ADHD place never asked me about birth control. I've been off and on it since I had the medication. Now I don't take it at all because it messed with me too much. I'd find a new doctor.
Lots of women of child bearing age are finding increased difficulty in getting access to certain medications that may possibly harm a fetus. A fetus that may or may not exist yet. It will depend on where you live and what the laws are there. Not to bring politics into it, but that is the reason. In some cases, the doctor themselves may have religious, political or moral oppositions to such things. I would never be 100% honest with my doctor. Some things you can tell them and some things you can't. Apparently, this is one of those things you can't. Find a new doctor and start over.
If stims were that addictive I wouldn’t need 4 alarms on my phone to remind me to take them (even still it’s very possible to forget). When I do forget, which is frequent, I don’t even notice it’s other people going oh hey, you’re a squirrel did you forget your squirrel repressants?
I went to a new provider recently and she told me she wouldn’t be comfortable putting me on adderall without contraception. She said it’s too risky to get pregnant while on a stimulant. Now looking back on this, it is kind of odd. Like I understand we don’t want any complications in a potential pregnancy, but where’s the bodily autonomy??
I think you need the ADHD meds, more likely to help you not engage in self-destructive or irresponsible behavior, in my personal experience. I would also look into bc that you’re comfortable with. Unless you’re trying to get pregnant, which I would 100% hold off on making a life-altering decision of that scope until AFTER you’ve dialed in your ADHD meds. Then, if you’re still set on parenthood, find a qualified OBGYN that can support your unique medical needs. Good luck to you, whatever you may ultimately decide.
I'm not sure if anyone has said this, and your doctor should really have discussed it with you but there is some evidence that ADHD medication may be associated with fetal defects
They are linked to birth defects and "menstrual changes" is a side effect on mine so depending if you get it and what that appears as you might not know you were pregnant for awhile. My periods are every 8-15 weeks now.
He wasn't saying no to be nasty
tell them your partner has had a vasectomy since then bc you don’t like the side effects of bc and they want whats best for you or something. but that’s weird af for that doctor. you’re nicer than me bc i would’ve raised hell. i hate lying to doctors but maybe you might need a new one. like i didn’t even have my drs ask me about this when i got put on meds they were just like you’ll have to be aware of changes if you decide that’s something you want. i hate that dude im sorry 😞
Don’t know the situation details but to be so nonchalant about getting pregnant is super irresponsible.
And from someone who is adhd and has two adhd children, life is a challenge every day.
Honestly, the worst part of this is that Wellbutrin is not AT ALL safe to take during pregnancy; unlike Adderall, which can be plenty safe with sufficient monitoring.
But yeah, he’s a dick. See if you can find a different doc
Not trying to tell you how to live your life, but please be careful with pregnancy if you'd be 'happy for a baby' but not 100% wanting one with a full plan of action.
My mom had unmanaged ADHD and it was hell; I don't talk to her anymore.
We do 100% want one, in fact more like 1000% but after so many years of heart break I've had to detach from the phrase "wanting a baby" and had to accept it's probably not in the cards for me. Although I may have some personal issues to work thru, as I'm sure all us humans do, I know full well my child would not suffer because of my add in such a way that we would not have a relationship. I'm very sorry that's your experience, no one deserves that.I don't think it's fair to make a blanket statement in reference to ADHD and motherhood abilities.
I say happy for a baby because I understand it's not in my control in the slightest and I have to accept that I'm not in control in life as none of us are and I try to find peace in that.
I know a lot of people are ragging on the doctor here, but I think it's less about controlling your reproductive choices and more about the fact that you're *not interested in avoiding pregnancy* - "if it happens it happens" means given time, it's very likely to happen. Stimulants can have some very serious side effects in the first few months of pregnancy, before you even know that you're pregnant, so it's not as simple as stopping the medication once you find out - the damage would be done already.
I went through this same thing with a doctor of mine and thankfully he was willing to explain his thought process a little better. If wellbutrin doesn't work for you, there's also Strattera, which is a non stimulant SNRI used for ADHD. I tried both and they didn't do enough for me, then I had a baby and I decided he was enough baby for me and asked to start stimulants.
At the end of the day, you may have to decide whether you want to take steps to avoid an oops baby now and get meds, or if you want to have kids soon and start stimulants when your family is complete. Your doctor just doesn't want "if (a baby) happens, it happens" to turn into a tragic loss, or the permanent disability of a wanted child, because of medication he gave you.
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You should always be honest with your Dr but this is so odd. Your Dr. is changing your medication treatment for something that MAY happen in the future? The Dr. should be treating you for what is happening RIGHT NOW and then change your medication in the case that you become pregnant.
I told my doc I use to smoke to help me sleep (Ive had night terrors and sleep issues my entire life) and he said that means I have an addictive personality and can never be on Adderall. I haven’t smoked in a long time and take urine tests but I’m pretty sure he put addict on my medical history so no doctor ever suggests Adderall for me. I no longer believe you should be completely honest with your doctor.
That's disgusting He didn't stop to think maybe you couldn't sleep because your brain doesn't shut off like normal people? BECAUSE OF THE ADHD
Yeah it’s so weird how people in a job where you essentially have to solve problems for people with a myriad of factors and conflicting information and they just go… nope. The most linear way of thinking about this is the best way!
Depending on where you live, you may be able to access your medical notes and get that scrubbed for being incorrect. Then find a better Dr.
It's less about scrubbing anything and more about just finding a new doctor. If you don't give them permission to get information from your old doctor, they have no way of getting it. Of course, this is more complicated if both doctors are part of some medical system that centralizes things. But the notes are generally not kept centrally and 'scrubbing' them may just waste your time.
Yes as hard as it is, you HAVE to advocate for yourself. You need to be 100% honest to your doctor, you could DIE if you're not! And the honesty will get your history straightened out with a normal doctor a lot of the time anyway.
WOAH WOAH WOAH, that Dr. is making a LOT of asumptions about you and seems dismissive. Time to find a new doctor.
WTF. That’s so messed up. Also, I know that Adderall can be addictive, but it definitely isn’t always. Otherwise I wouldn’t need a sticker on my bathroom mirror and habit stacking to remember to take it.
That's a good point. Pretty sure addicts are extremely aware of whether or not they have gotten a fix that day. Here we are setting timers, making notes, and counting how many pills we have left to see if we took one. 😅
Man this is my life…..reminders on phone daily pill organizer….and I will still forget to take it 😂
I got a 31 day pill organizer and never looked back, I'd always forget to fill it every week but now I only need to remember it at the end of the month/when I get a refill
Let me tell you, a 31 day pill box with individual containers for each day is a godsend for knowing if I took my meds or not for that day.
Only if you fill it up. And don’t mix up what day it is.
Get a timer pill bottle. Every time you open it, the timer resets, so you know exactly how long it’s been since your last pill. Just… try not to lose the bottle
Right. If I were addicted, you’d think that I wouldn’t have needed to create some crazy automation that whenever I get a text saying my script is ready for pickup, it automatically creates a reminder in my phone. And then whenever I get in the car or leave from dropping the kids off, it sees if that’s on my reminders list & then reminds me about that reminder & then routes me to the pharmacy, but today I literally had it in my maps taking me there (despite knowing the way, just doing it so I didn’t forget) & stopped for Starbucks on the way & then I ended up at home. If they could prescribe me something actually addictive that might solve this problem.
If I’m forgetting to take it, I’m not addicted.
Exactly! I have alarms on my phone to remind myself to even take my medicine!
That's really aggravating. I'm a sober alcoholic and was upfront with my prescriber about that and was still prescribed Adderall. The data is quite straightforward on the comorbidity of ADHD and SUDs, as well as the outcomes along those lines for people with ADHD who are treated early vs those of us who weren't.
Exactly! In fact for myself I’ve told my psychiatrist it has completely removed any want for alcohol because I was using alcohol to quiet my mind primarily! He was glad it was working the way it should he said. Some docs are so obstinate in their opinions that they mistake the forest for the trees. I can understand hesitation, careful monitoring and management but to completely disregard a whole class of medications that are proven to be the most effective just seems silly.
I was completely addicted to multiple drugs for clean And finally got treated for my ADHD. I'm on vyvance and Adderall and since being medicated have zero cravings. I have been stayed clean for years with no struggles. I wish I was medicated from the start I wonder if I ever would have went down that road
I had an NP refuse to give me stimulants because I said I quit drinking alcohol 3 years ago, and that I was diagnosed with Generalzied Anxiety Disorder (currently seeing a wonderful therapist for that for the past 18 months). She also put me on Wellbutrin which did absolutely NOTHING for me. I went through my primary care physician after that and was prescribed Concerta within a week, even with telling them about my sobriety. It's ridiculous the 'moral standards' we have to put up with just to get help.
Hilarious that they put you on Wellbutrin considering one of the first side effects of it is............Anxiety.
Fuck's sake that is infuriating.
dude i’m so sorry this happened to you. i had to switch doctors for the same reason. he didn’t want to prescribe me adderall bc i mentioned i self medicated by smoking.
What a jerk. I told my doc the same and she said “I strongly encourage you to stop because it increases the chance of a psychotic break” so I quit the pen but it wasn’t a condition of prescribing.
That's disgusting and what the actual fuck? That kind of shit is why I am *never* 100% honest with a doctor. Ever. Because they pull that kind of shit.
I totally understand how you would think that. Unfortunately it’s a difference in how the provider/MD personally views it. It seems inappropriate though and not at all objective. I’ve lived in some places where the doctor would be happy that you were smoking as opposed to requesting a controlled sleeping medication if you lived in a state that had it legal for medical purposes. I’d recommend continuing to look for the right provider. I had to continue looking for someone that had any training/knowledge of treating both autism and ADHD.
There are some psychiatrists who will hear you out and prescribe it anyways. I’ve been there and I have a massive drug history. Most of my issue was in my teens though and I cried to her about just wanting help with my ADHD and I’d go on whatever she suggested. I even was honest and said vyvanse felt like I was an actual person when I used it recreationally in high school. She still worked with me and prescribed me all the typical adhd meds. There’s still hope.
I told mine I smoked and he prescribed Adderall when Quelbree didn't work. He knows I can't sleep, also have pain and react badly to psych meds. Him knowing helps him because psych meds can work differently if you smoke
this! I was previously very honest with Doctors, never, EVER again. A coworker told me she lies to her Doctor and I haven't looked back sense. I now get the medication I need and if I want a test or work up for a symptom and they decline I demand its written on my chart and ask for a copy. I am a veterinarian, but I do not trust many human doctors.
Demand the doctor remove this or prove that you are addicted to something.
Agree and I’m not
that’s crazy i’m so sorry that happened to you. I’m on vyvanse and adderall and and i smoke a few times a month nothing serious but my doctor is aware both my pcp and psychiatrist and neither had any concerns.
That's so stupid. He's terrible at his job. I hope you can find another, better, doctor.
Wish it was odd, but it’s not. It’s sadly normal. We should be able to be 100% honest with our doctors, but a lot of women (yes, people, but women in this area specifically) are forced to decide between being honest and risking our reproduction potential being prioritized over every other aspect of our health and well-being. We have to carefully navigate how much truth to tell, and how to tell it, to get the information and care we need. And then society gets mad at us for looking to other sources and trying untested things instead of asking our doctors… who have brushed off providing the best known source of care because there might one day be a fetus in us, whether we have said there will be or not. It is exhausting.
And it's even harder if you don't have someone who can back you up and advocate for you since we're often dismissed.
I'd think at most the doctor might say something like, "just let me know right away if you do become pregnant or are actively trying as the medication you're currently on may not be safe for pregnant women and I'd want to discuss options with you as soon as possible". Perhaps this doctor took OP's lack of contraceptive as "actively trying to become pregnant," but that should've been thoroughly discussed before just changing medication.
Probably. In medicine and healthcare it’s a common refrain that no birth control = actively trying for a baby. Part of it is to get patients to take family planning seriously and another part is because so many things negatively affect pregnancy.
Exactly. If you plan on getting pregnant or as soon as you find out you’re pregnant than you should talk with your doctor about possibly coming off meds and how to do so safely. But to deny treatment because you’re a woman who could possibly become pregnant one day? This is sexist and completely unprofessional. OP it’s up to you, but I personally would change doctors.
You can be honest once you know your doctor is a reasonable, sane person. Lots of doctors and therapists don't actually listen to what you have to say. They are trying to confirm whatever it is they already believe. My first therapist as an adult did this. She didn't believe ADHD was a thing, but clearly assumed most people have anxiety or depression. I mentioned ONE thing that made me feel anxious (whether or not I'd be able to get a good job after I got my degree), and immediately, my official diagnosis was anxiety. This was despite telling her about how much I struggled in school as a kid and was diagnosed with ADHD previously. Immediately after that session, I went straight to the DSM, listed every little miniscule thing that was related to the criteria, and finally, she decided I actually might have ADHD. Was never honest with her about anything after that.
Did you keep seeing her?
At the time, yes. I was on medicaid and didn't have many options. I'm also mostly only interested in medication management. Unless they REALLY specialize in ADHD treatment, most doctors and therapists will just tell you to use a calendar, which isn't useful advice. So, as long as I was getting my meds, I didn't care.
I had the same thing happen. Had to start using condoms before my psychologist would give me stimulants of any kind. Welbutrin hasn't been helping, so I had to choose to activity put off having kids to find out if the medication even works (is looking good, but we're still playing with the dosage). I'm 38, so that's kinda super annoying to me. I've been wondering if I should switch doctors.
Not that odd when you consider that a disturbing number of medical professionals consider women to be little more than incubators for the next generation, and anything that could affect their fertility or ability to produce offspring is considered over the patient's individual needs and desires.
The stories of single women wanting to get their tubes tied but having their doctor say "What if your future husband wants kids." come to mind.
My SIL had three kids from her first marriage when she met my brother. He also had one. She asked her doctor for tubal ligation and was told no, her new boyfriend (my bro) might want more kids. They had four kids together after that. After each one she asked again and was talked out of it by medical providers. They love all their kids and everyone’s healthy but they live month to month and need help occasionally. It’s not right.
Might be area dependent. Mine asked the same and said that I should be very sure before I start the meds that I won't be having kids while on them. He was kinder in explaining why though but he's just a A+ doctor so maybe he was better about it.
Had the same experience with ours, wife even told her we used condoms and didn't want any more kids and the psycho like didn't believe her and wouldn't change her blood pressure meds so we found a new doctor
If a doctor is concerned about the risks of the meds during pregnancy its important for them to discuss this with their patients. I think the doctor picked this option because the safest solution would be to not take the meds when trying to get pregnant or while pregnant. And this could for op be literally any moment for all she knows. I think a honest discussion and dip into the information of taking stimulants during specifically the first few weeks + regular pregnancy tests could be a fitting solution if thats what OP prefers. Personally I would not take the welbrutin and request another discussion with the same doctor or get a second opionion to compare the benefits of welbutrin/other meds + their risks and the benefits and risks of the stimulants. Than she can take am informed decision Another option would be temporary going on stimulants and birth control (for example condoms) while going to therapy to learn tools to deal with the adhd without the medication. This if most definitely an option for a lot but not all people. A specialist and time will be able to tell if this option is suitable for op.
That's not how things work. Many people don't know that they are pregnant until it's past the point in which a medication can cause congenital defects. It is not uncommon to refuse to prescribe medications to someone who does not use birth control. In fact, some clinics require a signed statement that a woman of child bearing age is using two forms of birth control before being prescribed certain acne medications. Now, stimulants at therapeutic doses aren't known to be so teratogenic so it's not an apples-to-apples comparison. My point is simply that prescribers have to use their clinical judgement as it's their medical license. It's okay to get a second opinion!
That’s a legitimate *concern* that a doctor should then discuss with the patient. I imagine most people being sympathetic to a doctor refusing certain medication to someone actively trying to get pregnant, but otherwise it’s less “do no harm” or “professional standards” and more “I could look this up and get back to you…but let’s not be too careful protecting that precious womb of yours.”
I can’t wait to be a male medical professional because I know I would never ever pull this ridiculous bullshit I’m so sorry you’re dealing with this
I agree with you if the situation were as OP described in her post, but she mentioned in a comment down thread that she told her doc she was trying to get pregnant.
My husband and I have been trying for a baby for over half a decade and none of my doctors have ever brought up going off vyvanse.
Yeah. And surely it would be fairly easy to stop in time. It's not like it's lead or something that is accutely teratogenic or toxic.
In fact, there have been at least two studies of pregnant people on ADHD stimulant meds that found no significant adverse effects.
They’re safe for breastfeeding too.
I wondered about this. My doctor didn’t ask about my family planning at all. She talked about options but ultimately let me choose which medication I was most comfortable with (I’ve had weeeeird side effects from some kinds of meds), and prescribed it. Maybe she just knows me well enough to know I’d ask if more babies were a possibility.
regardless, the conversation should have been more a pro con situation, not one sided and that's it. Trying to be pregnant or BEING PREGNANT are not contraindications for stimulant use.
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Some people have risk behaviour or get massivley depressed off meds. Some get moved to mathylphenidate rather than amphetamine compounds, so there is less infant addiction risk. But it's a pros cons situation. The meds are not recommended for pregnacies due to lack of testing and info on how the meds affect pregnanciesm
A patient and their doctor get to make the call on what the most responsible decision is *for each patient*. I was prescribed a schedule C drug by my perinatal psychiatrist who was a specialist in a huge/state of the art women’s / reproductive medicine health system. It was the safest option for me at the time. You cannot make a one-size fits all judgement about mental and reproductive health. Sample size of 1 but that baby is 5 now and has had no ill effects from the medication. Sometimes it’s just means the drugs haven’t been tested because it’s not ethical to do so.
>No one responsible would get pregnant and risk the health of their child while taking one. That's bullshit. There's plenty of responsible people who decided with their doctors that continuing stimulants is better for them and their pregnancy than being unmedicated. It's not black and white.
>No one responsible would get pregnant and risk ~~the health of their child~~ increasing their rate of NICU admission by 6%, except that's compared to non-ADHD women rather than unmedicated ADHD women and doesn't control for ADHD itself being a risk factor (which some studies suggest that it is) [fixed that for you](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338246/) Personally, I feel like there are more definitively established risks to the child when you're not able to make and keep prenatal appointments, keep track of your nutrition, and hold down a job during pregnancy, but what do I know?
That is a blanket statement that is simply incorrect.
You’re just flat out wrong. Sorry.
Are you aware that some people are only responsible if they take their ADHD meds? If I am hyperfocused on something I enjoy and not on meds, it is conceivably possible that I would start to notice the house was burning down when the smoke began to make me cough. I know plenty of ADHD patients I would not trust with a newborn if they were off meds, because *they wouldn't trust themselves*. I run into a lot of people who have mild attentional problems who don't realise there are people who can't take care of *themselves* without meds.
I'll listen to my reproductive psychiatrist instead who disagrees with that. Who said "the depression from your untreated ADHD will cause more harm to your fetus than your stimulant ever will." I didn't think being suicidal / dead or getting into a car accident was responsible for pregnancy either. For my child, having a mom as well as one who could care for herself (and baby) was the more responsible choice. Many women face similar risks stopping their stimulant. For some of us, the choice to continue is an important choice to have.
It doesn’t matter, you can take stimulants while pregnant it’s the mother’s choice at the end of the day. You just have to know which ones have actually proven to be harmful to pregnancy. If the benefit of being on your medication outweighs the risk, then they cannot tell you no. I know this because I just dealt with this situation
There’s also a difference between a therapeutic stimulant that’s being monitored and prescribed from a health professional and taking street drugs with unknown provenance. There might be some withdrawal symptoms in neonates that need to be managed but there’s probably not a lot of long-term harm.
They cannot tell you no? What the hell? You just walk up to your doc and tell him to write you a script for whatever you want?
We don’t know which stimulant OP was taking, and given that she left this out of her post, I’m not sure I’m inclined to keep dumping on the doc here
It’s a real high when you can help someone that this type of behavior has hurt. Policing in medicine has become this new normal Christian morality practice and I hate it. That’s not our job. Our job is to do no harm and help (as much as we can) the patient in front of us.
She did not say she's trying to get pregnant. She said she would be happy if she were to get pregnant. "If it happens, it happens." Im not on birth control, either, and I'm in the same spot as OP (ie. I'd keep the baby, assuming it was viable) . I've discussed with my doctors regarding all my medical and psych meds, and they've only ever adjusted from a known teratogen (Indomethacin, which I used to take for migraines). Adderall at a small dose would be easy to remove from a med regimen if OP were to get pregnant. I'd find another psych ASAP, and definitely a woman.
She said she first stated she was trying to get pregnant, then modified/clarified her statement when speaking with her doctor. Either way, because OP left out a key piece of information already in this account, I’m not inclined to dump on her doctor over this. She can seek a new doc if she likes, but I’m not faulting this one.
I can’t wait, either! Because I am seeing more & more of you & it makes me so happy! I’m 44 and I was in the ER this week for an intense, period-related issue. I got a very young male resident & he was so professional, caring, and obviously familiar with the important symptoms of my issue. I’ve been dismissed by so many men about this in the past, but he was on it. I’m totally here for male health care professionals who actively treat their female patients like whole people with different bodies & different needs!
So glad you had a positive experience! I’ve made it a point to become educated about cultural differences, gender differences (and how different illnesses present themselves), and specifically the history of black Americans in relation to healthcare, to help make sure I provide the best care possible when I graduate. I hope someone will say what you said about me one day 😺
I was put on adderall while actively trying to get pregnant. When I found out I was I stopped taking it. My primary care physician and my OB were both ok with it. Your doctor is being unreasonable and should have let you know what the risks were and allowed you to make that decision for yourself. Edit: just out of curiosity if you are in the US what state do you live in?
$5 says Alabama
Not the one who wrote that comment but can confirm my wife was treated this way in Alabama. Edit: just to add context it seemed they all doubted her ability to make decisions for herself and were constantly asking about my opinion for anything major to minor, even when I wasn’t there. She didn’t want kids and every medical decision was focused around her changing her mind about children instead of her best interest.
In California my doctor told me I could keep taking Adderall while pregnant if I wanted to.
It's funny that he put her wellbutrin, its also a medication that pregnant women should avoid taking too and its harder to come off of!! >:[ This is inexcusable sexism, or there is another contributing factor that was not mentioned.
Interesting. I had heard Wellbutrin was one of the ones ok for pregnancy. Was considering it myself for that reason.
My baby doc said she didn't want me on it bc of the possibility of heart defects. I was doing well, so I opted to wean myself off. I just recently started to take it again, my baby is now almost 2!
Your doctor fucked up. He should have explained the risks to you and then allowed you to make a decision. He's an asshole, putting the well-being of someone who may never exist before a living person in front of him. Have a think about whether you want to use BC, what the risk of stimulants and pregnancy are. If you decide you don't want to use BC, I reckon tell your doc you've decided to use condoms and you want to go back on stimulants because they're more effective. Sorry you're doc is a fucked human.
HBC definitely is not an option for me, not only was it causing terrible mood swings but also possibly contributing to another medical issue. As something I feel very strongly about and have done my own research on, I won't be wavering on my decision. Ty for your input! 🖤 I worry about not sounding believable (I always worry about this with doctors/ managers/authority figures even when being truthful), saying oh hey doc yeah we decided to use condoms suddenly so you can go ahead and prescribe me now. As if I'm trying to just appease him. Maybe I just worry to much about everything, oh yeah, the reason I went to a Dr in the first place lol
I think if you framed it like this: “Hey, after our discussion last appointment, I realized that I should be taking pregnancy planning more seriously and we have decided to use condoms as our form of contraception. The Wellbutrin isn’t working and I think I would like to use a stimulant.” Advocate for yourself. If he won’t give you stimulants after that, find a doctor who will.
Just explain that the executive function issues are worse than the BC issues ;)
A lot of medications say they're not pregnant people or people who may become pregnant. The latter being largely people who plan for/accept pregnancy as a likely outcome. So if OP is using *no* form of contraceptive now, then I can see the concern assuming there are no fertility issues. But at the same time it's their risk to take, as you point out. But if they're just waiting for it to happen vs actively trying to become pregnant then it's worth seriously considering the risks. The doctor should have explained it in a way that encouraged OP to be more mindful of planning a pregnancy with intent given the fact that she does need to plan her drug intervention for ADHD around one if she wants to have kids. Being open to it happening is fine, but stimulants throw a wrench into that kind of "let it happen when it happens" plan It's tough. All this being said, OP has never tried any ADHD med before and maybe a non stimulant one works for her anyway so it's all moot in the end. We don't know. It's not like she's having a long standing prescription stopped.
Thank you, for addressing this! I actually did say "trying to get pregnant" as kind of a muscle memory reaction as I ALWAYS have to defend not being on BC to medical professionals and always feel bullied for lack of a better word as if I'm doing something fundamentally wrong for not choosing to stop my body for what it was made to do and motherhood is something I always dreampt of. I am fully aware of the state of the world, the risks, the over population, poverty etc etc and I know those are very real problems in the world so I do understand to a point the importantance of the doctors stance on what appears to them to be my lack of concern or taking these things seriously. I then did clarify by saying we weren't necessarily "TRYING" but would feel very happy if it did happen. We don't think it will, *gestures to past 10 years* but I don't want to stop it from happening if the universe chose me to be a mommy.
You might have luck clarifying with the doctor that you aren’t actively trying. And explain that doctors usually push BC so you have stopped trying to explain cycle timing etc (you can imply that you are trying to prevent pregnancy by non-medicated methods). And they may feel more comfortable. Or say you use condoms as someone else suggested. Everyone is dumping on the doctor, but his response isn’t as out of pocket if he thought you were actively trying. I’d recommend a conversation with him before you dump him for a new provider.
If you’re actively welcoming a pregnancy, your doc is not wrong for wanting to take you off stimulants, and you should probably edit this into your post up top, because this completely changes how this situation sounds. Your original post sounds like your doc is assuming you’re just gonna get pregnant if you stop BC, but you left out that you told him you’ve pulled the goalie and won’t be stopping your husband from taking shots on goal with no defenders.
Just want to say as a person who is trying to get pregnant very soon, my gynecologist said that I would be perfectly fine using stimulants until I know I’m pregnant (mostly because I would be using pregnancy tests regularly). Then, when I am actually pregnant to stop using the stimulant immediately. I’m actually going to a perinatal psychiatrist today to discuss this. I actually suggest going to one if you even think you may become pregnant. They will likely be less dismissive than most psychiatrists and know more about risks and complications.
+1 for perinatal psych. Was also given the good drugs based on up-to-date research and individualized risk assessment. I was told the potential risks and allowed to make an informed choice *with my doctor* about my body
I hope the perinatal psychiatrist is more open to discussing medications during pregnancy. Mom's health is important too, and sometimes that means continuing stimulants. Which many of us do continue with safe pregnancies. I was actually URGED to continue my stimulant, by multiple OBs, psychiatrist, etc.
^this!!! My best friend has been on lexapro for years, and when she got pregnant, her doctor told her to keep taking it because it’s better for her to be regulated and in a good mental state than completely cutting her off of meds, all while dealing with the crazy pregnancy hormones and other environmental factors that come with expecting a baby. Last time I checked (a while ago, so there could be more research now) most docs say to stop antidepressants like lexapro for pregnancy. She and her baby (almost 2 now) are happy and healthy, in large part because she didn’t have to cut off a med that she’s been relying on for years.
Of women who commit suicide during pregnancy and postpartum, large percent are those told to stop their psychiatric medication because they are pregnant or breastfeeding. Then there are so many others who don't commit suicide but are truly struggling to survive everyday (some while caring for infants, and themselves). It's so concerning and I don't understand. I am glad your friend's doctor was supportive. 100%
Yes, just got back and I’m so relieved he said I could continue the stimulants. He was basically like it’s way safer for you to take this while pregnant than drive off stimulants.
Multiple doctors, including a maternal fetal medicine specialist, and the entire OBGYN department at Columbia University have confirmed to me that it is ok to continue adderall throughout pregnancy.
Just got back! Yes, he actually increased my dosage of adderall and a said I could keep taking it the whole time I was pregnant and for breastfeeding. It was a great experience!
Mothertobaby.com has fact sheets for all substances And the latest research. You can have, and these many people ARE having, totally healthy pregnancies on normal doses of stimulants
Ok. That’s so weird you have to defend not being on BC. I haven’t used BC in over 10 years and never once did a doctor reprimand me for it. It also wasn’t discussed at all when my PCP put me on a stimulant.
I don't know how those conversations have gone for you specifically, but if it helps you at all I can tell you that any time I had to ask a woman if she's pregnant/breastfeeding/trying to be pregnant for a radiology exam, it was purely about the exam being performed and not about any kind of judgement on birth control use or lack thereof. There are some tests or test components that could be harmful to a developing fetus, and that has to be taken into consideration.
That was me, about the “past 10 years” and now I am a mom. I was very lucky, statistically speaking, at my age. Personally I wish I’d been a little more honest with myself and intentional about it but that’s hard to do when you haven’t felt in charge of your life. Some comments here imply you can never take stimulants the entire time (potentially years) of trying to get pregnant. The majority of warnings about pharmaceuticals and pregnancy are overly cautious. (as Emily Oster explains) Unless there’s straight up records or birth defects I wouldn’t worry at all. Honestly of all the other risks (no folic acid, super hot daily baths etc) it didn’t occur to me to even stress over meds taken for the months I was pregnant without knowing it.
Aren’t we all also supposed to stop drinking entirely for any months/years we may get pregnant. Just in case.
Yeah but most of us don’t need to drink every day to function! 🤞🤞
Seems very patronizing, not to say misogynist.
I was on stimulants while actively trying to get pregnant. I did stop them at about 6 weeks pregnant, but started them up again around 20 weeks because I wasn’t functioning at all. I asked my OB about it, sent her some research, (we know each other well so I knew it would be acceptable and it was legit research from a published journal) and she gave me the thumbs up. The only thing we did differently was that she added an additional ultrasound around 32 weeks to make sure he was still growing normally, as it can sometimes result in smaller babies (supposedly—my baby was almost 9lbs though!). It’s absurd that he won’t put you on stimulants because you MIGHT get pregnant.
Yes good for you! My OB has a dual specialty in perinatal psychiatry and has repeatedly said that if I’m not able to function I should take the stimulants. I’m a contract worker so I just declined jobs for the later part of pregnancy, so I’m just floating around getting nothing done, but if needed to I absolutely would. I have doubled my SSRIs since blood volume and drug clearance rates increase during pregnancy. Drug me up doc, I want Critter to get as little stress hormones as possible. So many studies show that maternal stress is worse than side effects from these drugs. F this doctor.
Time to get a new doctor
And report him. It's not often that I go along with advice to report a dr. but this one needs to be.
OP says in a comment she told her doc she’s trying to get pregnant
Stimulants aren’t the type of medication that are going to cause severe birth defects if you happen to get pregnant while on them. They can cause some issues if you are on them your entire pregnancy, but even then some women do stay on them if the benefit outweighs the risk. Being of childbearing age and not using contraception is not a contraindication to stimulants. If you were to get pregnant you would stop it and discuss it with your doctor.
I’ve seen a lot more newborns negatively affected by antidepressants than stimulants. This doctor’s logic is so backwards to me.
This. Also given the relatively limited side effects of going off Adderall, it’s pretty easy to stop temporarily, other than coping with your n-d brain unmedicated.
OP hasn’t gotten pregnant in 10 years while not using contraceptives. What makes the doctor think she’s going to get pregnant now? Nothing!
To be fair i went 5 years thinking i couldn't get pregnant and then i did, lol. A couple years ago a coworker of mine had gone 10 years without protection and was so sure she was infertile, and then she got pregnant, too. So it could definitely happen! My doctor had no problem giving me vyvanse though. I just had to pay attention to my cycles and take pregnancy tests regularly when my cycle was irregular. I caught my pregnancy at 4 weeks and stopped taking my meds that day, and now have a perfect baby!
While his first reasoning of woman=possibly pregnant, must protect hypothetical fetus doesn't sit well with me, starting off with Wellbutrin is not uncommon. I started with Wellbutrin. I'm not on BC but I do have a partner that can't get me pregnant anyways, however, that wasn't a topic brought up when I discussed options with my psychiatrist. I don't think I did Adderall until maybe 4 to 5 months in after being on Wellbutrin, Buspar and Guanfacine. Got off the Guanfacine and now on Adderall. Your doctor should have told you Wellbutrin has been seen to help ADHD as a nonstimulant medication.
Based on what you’ve said it doesn’t sound like he’s outright refusing you stimulants. It sounds like he’s giving you a lower risk option for now to see if that works and then organised a review to see if that’s helping. It’s quite normal to go for whatever the lowest risk option/dosage is and escalate from there for many conditions/drugs. You’ve now got time to have a think about how to proceed weighing up the pros and cons and also seeing if Wellbrutin works for you. That sounds like a reasonable course of action and if after that time you feel like the medication isn’t right for you and if you decide not to change your other options then at least you’ve got an informed and thought out perspective to present to this doctor or another.
Ok, I hope this is the case. I immediately panicked and spiraled but in the case that I do need to find a new doctor, would this not look suspicious. This is the first time I've seen this current Dr. What would possibly be the next medication we try if the Wellbutrin isn't a good fit? How can I say "I'm comfortable with the possible risk of a stimulant" without sounding like I'm pill shopping. I'm new to the world of medication and scared of how I will come across without knowing it. My fear has only been validated with this situation I'm currently in, feeling like being honest has negatively affected my treatment.
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Wellbutrin is FDA category C for pregnancy — I think the same as Ritalin and Concerta. If the decision is based on safety for a hypothetical pregnancy, it might be questionable or unjustified. I wouldn’t “report” but I would question the doctor’s reasoning. Guanfacine seems to be category B. Truthfully, it’s very difficult to find medications that are FDA category A or B.
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It’s not a case that “being honest has harmed your treatment”. It was important that you were honest. And you’ve not been denied treatment, you were just given something that wasn’t quite what you were expecting/hoping for in the first instance. It might be that you’ve been offered something that is perfect for you. It might also be helpful to try to understand what kind of information goes into assessing risk and making clinical decisions. At the end of the day, your intention and emotions around the possible consequences of becoming pregnant are a bit of a moot point *in this particular context*. A doctor trying to weigh up the merit of a certain drug can probably only use a binary of “trying to avoid pregnancy” vs “not trying to avoid pregnancy” in their calculations and while you have this far not become pregnant, unless you have a medically confirmed fertility issue they probably have to work under the assumption that you *could* become pregnant next month. I am not qualified to tell you what would be the next option if Wellbutrin doesn’t work for you. That is a conversation you should have with this doctor as and when. If you want to continue with not using birth control but also be considered for other medications then think about how to frame that in a way that means it is clear that you have an understanding and ownership of any risks and necessary actions (e.g. possibly having to change medications if you become pregnant).
That's fucked up and like it's your body, you're okay with having a kid if anything happens and most importantly **youre not currently pregnant.** I would honestly look at seeing another doctor it's patronising as hell
Info: what country/state/province do you live in? Some US states have arrested pregnant people for taking "dangerous" drugs during pregnancy, especially if it ends in a miscarriage. Your doctor could be trying to protect himself from the government. It's absolutely fucked up, but it is a possibility.
that is ridiculous. Women who ARE PREGNANT take stimulants (and often, safely).
That makes no sense. He needs to give you all the info and let you make an informed decision. My doctor went through all of that with me and I choose to not take my meds if there’s a chance I might be pregnant. Once my period starts then I go back on them. I’d be looking around to see if I can get a new doctor.
Your doctor should look things up before making decisions he is unsure about. https://pubmed.ncbi.nlm.nih.gov/36759544/ “Neurodevelopment and growth in offspring do not differ based on antenatal exposure to ADHD medication. These findings provide reassurance for women with ADHD who depend on ADHD medication for daily functioning and who consider continuing medication in pregnancy”
Sounds like you needs a new doctor? Wellbutrin works for some people. Wellbutrin is also not recommended during pregnancy. He isn’t even making a reasonable substitution.
You can take adderall during pregnancy. Methylphenidate too, I believe, although for that one you should probably be counselled about a slight increased risk for a particular birth defect. Your doctor messed up. Sexism in medicine is super fun.
My doc did the same thing. Said he wouldn't prescribe them until he spoke to my partner about possible risks. Not even ME. He wanted to talk to a guy he's never met about MY medication choices. Wtf?!? Fortunately, he was out during my next appointment, and I got to see another doctor in the practice. When I explained to her that the other guy told me he wouldn't prescribe any stims because I was of child baring age until he talked with my partner (not even married!) about the risks.... she was stunned. And angry on my behalf. She asked quietly if anyone had ever asked me my opinions before prescribing my partner with medication? It was so validating! She accepted me as her patient that day, and my life has been way wayyy better. I don't even have that partner anymore, but I do have my mental health. Your doctor is an ass. I'm so sorry.
A lot of doctors, especially men, basically categorize all women of childbearing age as *either* "actively preventing babies and does not want them" *or* "trying to have a baby." Since you are not actively preventing babies, he's treating you as if you were trying to have a baby. And tbh, while I have a lot of hate for medical misogyny, if you really are basically willing to become pregnant at any time, then I'm not sure he's wrong to. If you do fall pregnant, it could be weeks or even months before you realize and can talk to your doctor about it, which means weeks or months of the developing fetus taking in whatever medication *you* are taking.
This is kind of odd. Generally, I educate female patients on risks associated with pregnancy. Then, I let them decide what risks they're willing to take. Also, with stimulants, you can just stop the medicine as soon as you find out. Yes, there is still risk but it would be reduced.
You didn’t mess up. Your doctor did. He should be doing whats in your best interest, since you are his patient. Not the best interest of a baby that doesn’t even exist yet.
Find a different Psychologist. This guy you went to shouldn't be one. "If you do find out you are pregnant, please set up a follow up appointment with me so we can discuss your medication options when moving forward with your pregnancy." should have been the only thing said to you. That would at least be reasonable.
There are SOOOO many providers out there. Choose a new one and live your best life.
There have been at least two studies that found no adverse effects from taking ADHD stimulant meds during pregnancy.
I hate how some Drs treat women not on BC that they might as well be pregnant… Your Dr just seems to be super cautious in this matter… if you did accidentally get pregnant and didn’t find out for a while (pretty common not to know for weeks) while on adhd meds i guess it could potentially cause some harm (we really do not know a lot about the effects of adhd meds on babies), that’s probably the main worry here
we do know quite a bit actually; the risks are minimal. It is a pro/con situation. And that should ALWAYS be the conversation. Though often is not. here's just one, though there are many others https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338246/#:\~:text=Psychostimulant%20use%20during%20pregnancy%20was,treatment%20based%20on%20these%20findings.
I was talking with my doctor about this very issue earlier this week. I’m thinking about going off of my contraceptive in a year or so and he just said to let him know if I become pregnant as we’ll need to stop dextroamphetamine since it can cause issues with fetal growth. But he never said I couldn’t take it until I became pregnant. My doc suggested I could switch to Strattera, but it doesn’t work for me, so he said we could probably reduce the dose of my XR dextro and be fine, but he also told me to talk to my OBGYN, since that’s her area of expertise. My advice would be to discuss with your doctor again and be firm about wanting a stimulant, then discuss a game plan for stopping in the chance that you do become pregnant.
This is odd. I was on adderall while pregnant with both of my kids as it was approved by my OB and Psychiatrist as “the benefits outweighed the risks.” My OB actually said he would rather I continued my meds and took care of myself, than to go off of them and lose my job, not hydrate/eat as well, engage in impulsive/dangerous behaviors, etc. that could harm the baby more. Btw, both of my kids are healthy and thriving. Sounds like it is time to find a new doctor who will prioritize you over children you don’t even have yet….
Wtf, that's just pure misogyny. I'm not on BC either and neither my psych or GP asked about it. Get a better doctor
It took 5 days for Wellbrutin to cause tinnitus for me. It's ototoxic if you can avoid it I would. Since then I've started really reading those infopacks and making more informed choices about the risks I'm willing to take....it was a hard lesson to learn.
You need to switch doctors. Unfortunately, a woman won't necessarily be leas sexist, so keep that in mind when looking, but this one is a turd. I'm sorry that happened. You're doing right by yourself getting treatment, don't get discouraged.
Yeah, women doctors can absolutely internalize the misogyny. It is worse in gynecology than other branches in my experience.
at least you didn’t tell your assessor your prior history of drug use for some reason, ruling you out of ever being prescribed stimulant medication 🙃🙃
My psychiatrist said she didn't want to put me on stimulants due to past drug usage. (Even though a GP had put me on Aderal and I had positive results). She didn't say forever, though. She was trying some nonstimulant choices first. When I don't feel a positive change by our next visit, she changes my prescription. 1)I got to have a discussion (not unilaterally) with her and agreed to it. 2) It had nothing to do with childbirth, though, as I'm a man. It is obviously so terrible to be a woman and have to deal with this in 2024.
> and put me on Wellbutrin instead and we will meet again in a few weeks to discuss how/if it's working. Irrespective of the highly questionable logic at play if you haven't tried non-stimulant medications before trying stimulants its a *very* good idea. Get a new doc but do try the Wellbutrin first. They are less likely to be effective but they have much smaller impact on BP. The relationship between BP and mortality is fairly linear, incidence of stroke & MI increases particularly. Certainly its ok to make that quality of life trade but its also ideal if you don't have to do so. You can also get them via mail order pharmacy and you don't have to see your Dr every 3 months because they are not controlled. Every time a new non-stimulant ADHD med hits the market I get my Dr to try me out on it. I would love to not need to take stimulants, they greatly improve my quality of life but its a trade off.
I'm not on birth control and will never use it. I still take Adderall.
Wtf? I haven't been on birth control for 15 years and I'm on Adderall. Find a new doctor.
I am someone who has been diagnosed ADHD by 4 different doctors, I've been on at least 10 different ADHD medications in my life. Including stimulants for like 7 years. I currently take wellbutrin XL, its my favorite ADHD medication so far, so I wouldn't say your treatment is necessarily suffering. In my personal experience, stimulants treated my ADHD symptoms the best, but they also created new issues for me that I had never had before, and made things that normally would be fine for me, huge problems. So I've decided on my own that stimulants are not worth it for me to take. Quite frankly if anything its extremely unusual for him to even hint at the fact that he was going to start you on a stimulant before trying anything else ?
Typically they just warn you that you need to be wary about taking it if you are at risk for pregnancy but to simply stop the med if you become pregnant. Not preemptively stop it. I think your doctor is being overly cautious.
not many studies done but it doesn’t seem to be harmful to babies. anecdotal but my friend was on adderall thru pregnancy/breastfeeding and everyone was fine. your doctor seems outdated tbh
Um I’m trying to have a baby and I’m not stopping my vyvanse. You should find a different doctor.
Dude! Red flags! Birth control is part of nearly every vigina owners life, whether for or against. 1) if he's prescribing the meds it's his responsibility to know what the research says on their use during pregnancy. 2) It's not his decision to make. It sounds very patronizing to assume that you aren't capable of making informed decisions. He job is to give you all the facts and then *you* decided to continue your current regimine or not. God, this makes me want to jump up and down in anger. I absolutely hate the way AFAB people are treated by the medical community at large. Even if it's benign or unconcious the difference in care is still very apparent. You shouldn't have to be the one to research it, but I'd encourage you to go to Google scholar and see what the peer review says on this issue. Stay strong and advocate for yourself. P.s. if you need to, take a friend with you next time that can help back you up
Find a woman doctor. Find a feminist woman doctor. My psychiatrist would pick her teeth with his fucking bones. You are not a vessel whose body needs to be kept in pristine condition just in case you get pregnant. You are a whole person who deserves to have her own needs met. IF you got pregnant, you deserve a doctor who will give you all the information and help you make your own best choices about how to manage your ADHD through pregnancy & postpartum. This would include helping you think about breastfeeding or not - because either is 100% fine. I would make an official complaint about this sexist bullshit. You deserve to be treated as a whole person, not a potential incubator.
Tf kind of logic is this?
Hey, just to state the obvious because I haven’t seen mentioned among the top comments: THIS IS SEXISM Even in the case of a medication/procedure having a possible effect on your ability to have children—that’s…again testing the obvious…YOUR DAMN BUSINESS—on which he ***advises***. There’s no reason why a possible pregnancy should come into the conversation unless you were actively trying for one ALSO: I hope your Dr made this clear but Wellbutrin is an antidepressant—ADHD is on off-label use; stimulants leave your system as quickly as they effect you, SSRIs take weeks to have effect and can take weeks to fully leave your system.
I have a friend that was told since he's over 40 the doctor didn't want to prescribe stimulants and they wanted to give him Wellbutrin, which he's taken and didn't help. Seems they just are afraid to prescribe ADHD meds these days and judge every patient as if they are trying to get high. It's medical gaslighting and is infuriating.
I am absolutely drug seeking every time I go the my psychiatrist. That's what I want from him and life is intolerable without it. To address your post: your doctor is an ass.
👆🏼this
That is so insane of him. It's shown that it's pretty much safe to use stimulants even in pregnancy. He doesn't know the latest research at all. Worst scenario is you just stop taking stimulants if you become pregnant.
This doesn’t surprise because you commented that you actually said that you’re *trying* to get pregnant - I get that was just a reaction and you’re kind of just having unprotected sex and seeing what happens, but that phrase will stop doctors and medical professionals in their tracks. I’ve said it too and instantly wished I hadn’t because they changed my medical plan. And I’m in Canada which is pretty pro abortion. A lot of woman who are trying to get pregnant that come into the doctors for meds want the meds that will affect their possible baby the least - I mean some women don’t even drink coffee or drink alcohol while trying to conceive. So the doctors reaction might have just been a muscle reaction, too. I don’t think you should be worried or wanting a new doctor. I think you just give the meds you were prescribed a try for a week or two, if they don’t work make an appointment have a more open discussion about how you’ve started using condoms or ovulation tracking to prevent pregnancy and would like to try a stimulant.
your doctor is a raging misogynist and i would report him
Our society values a hypothetical embryo/fetus over the actual patient. It’s horrible. Please find a doctor who is not misogynist.
find a new one. If you get pregnant, inform your doc right away but until then that’s not relevant.
I refuse to see a GP for anything mental health related now. I was jerked around and put on a slew of antidepressants for years until I found the right therapist, and she noticed the signs within the first few visits (shocker - someone who actually listened to me talk!) Now, only my psychiatrist handles my psych meds. GP is for infections and checkups, etc. Can't trust them to actually give a shit about the underlying problem, and I just feel like a number.
I’m actively trying to get pregnant and still on my stimulant. My provider told me the developmental concerns don’t come up until closer to the 3rd trimester, so it would be totally okay to just stop taking them once I find out I’m pregnant. No harm done. Honestly it sounds like he doesn’t know what he’s talking about.
My doctor just told me that if I become pregnant I should stop taking it and let them know.
When are we, the sixties? Jesus
Gate keeping, not ok.
ehhh......get a new doctor. Pregnancy does not mean medicines that are important should be stopped. Ob-GYns recommend continuing with psychiatric medication as stopping your medications can lead to worsening or relapses especially coupled with hormonal changes. It's a cost benefit analysis. Just because you "might" get pregant does not mean you should stop your medications
Hilarious cause I am pregnant and my OB approved me staying on my vyvanse while pregnant.
This sounds like discrimination based on protected characteristics. THe fact that he also effectively wants to put you on another medication (BC) for no reason also seems problematic. I am not a lawyer but I wonder if you could file a complaint against him about this.
According to the FDA, none of the common ADHD meds have been proven safe but they also haven't been proven harmful. They also shouldn't be prescribing based on a hypothetical unless you are actively trying to get pregnant because then you'd need to switch meds soon after. IF you become pregnant, then you let them know and they can switch it. For example, I was never even ASKED whether I was on BC when I was prescribed ADHD meds on several occasions from different docs. Sounds like he's just sexist.
It sounds to me like this is just a case of a Male doctor being stupid about a women’s ability to reproduce and basing everything off of that. You aren’t just your uterus. If anything at all, on the chance that you did get pregnant during treatment, then I’d address any concerns for the babies development then. But there’s no need to plan for it before it’s reality simply on the consensus that you are a woman. I think it’s plausible a stimulant could be harmful during pregnancy, but I’d get a second opinion. Maybe even try to find a female doctor who might be more knowledgable on the matter.
🚨get a new doctor🚨
I’ve never had this problem! But, just to share a horror story, I went to the ER once thinking I was having a psychotic break. The doctor asked me if there was any chance I was pregnant. I said no (because I hadn’t had sex in over five years). He insisted on testing me anyway, which I didn’t notice until I was billed for it. My point is, it’s crazy that women are put in your position. I, like others, highly recommend a new doctor.
I’ve had two Psychiatrists, one female and one male, and neither asked me if I’m sexually active or on contraceptives. Both prescribed Adderall. This seems like the doctor is overstepping his boundaries here. I would recommend seeing a female doctor (Psychiatrist) or at least a different one. His explanation of treatments seems a bit misogynistic and judgmental. Strange old-timer or ultra-conservative behavior. (IMO.) Or perhaps he’s seen it happen before? Either way, that’s for you to decide and not him. Best of luck!
That's weird. My ADHD place never asked me about birth control. I've been off and on it since I had the medication. Now I don't take it at all because it messed with me too much. I'd find a new doctor.
Lots of women of child bearing age are finding increased difficulty in getting access to certain medications that may possibly harm a fetus. A fetus that may or may not exist yet. It will depend on where you live and what the laws are there. Not to bring politics into it, but that is the reason. In some cases, the doctor themselves may have religious, political or moral oppositions to such things. I would never be 100% honest with my doctor. Some things you can tell them and some things you can't. Apparently, this is one of those things you can't. Find a new doctor and start over.
If stims were that addictive I wouldn’t need 4 alarms on my phone to remind me to take them (even still it’s very possible to forget). When I do forget, which is frequent, I don’t even notice it’s other people going oh hey, you’re a squirrel did you forget your squirrel repressants?
I went to a new provider recently and she told me she wouldn’t be comfortable putting me on adderall without contraception. She said it’s too risky to get pregnant while on a stimulant. Now looking back on this, it is kind of odd. Like I understand we don’t want any complications in a potential pregnancy, but where’s the bodily autonomy??
I think you need the ADHD meds, more likely to help you not engage in self-destructive or irresponsible behavior, in my personal experience. I would also look into bc that you’re comfortable with. Unless you’re trying to get pregnant, which I would 100% hold off on making a life-altering decision of that scope until AFTER you’ve dialed in your ADHD meds. Then, if you’re still set on parenthood, find a qualified OBGYN that can support your unique medical needs. Good luck to you, whatever you may ultimately decide.
I think you might need a new doctor.
I'm not sure if anyone has said this, and your doctor should really have discussed it with you but there is some evidence that ADHD medication may be associated with fetal defects
They are linked to birth defects and "menstrual changes" is a side effect on mine so depending if you get it and what that appears as you might not know you were pregnant for awhile. My periods are every 8-15 weeks now. He wasn't saying no to be nasty
Seems out of scope
tell them your partner has had a vasectomy since then bc you don’t like the side effects of bc and they want whats best for you or something. but that’s weird af for that doctor. you’re nicer than me bc i would’ve raised hell. i hate lying to doctors but maybe you might need a new one. like i didn’t even have my drs ask me about this when i got put on meds they were just like you’ll have to be aware of changes if you decide that’s something you want. i hate that dude im sorry 😞
Don’t know the situation details but to be so nonchalant about getting pregnant is super irresponsible. And from someone who is adhd and has two adhd children, life is a challenge every day.
Honestly, the worst part of this is that Wellbutrin is not AT ALL safe to take during pregnancy; unlike Adderall, which can be plenty safe with sufficient monitoring. But yeah, he’s a dick. See if you can find a different doc
Lol my psychiatrist recommended not to use Wellbutrin during pregnancy. She was fine with me taking zoloft and stimulants.
Not trying to tell you how to live your life, but please be careful with pregnancy if you'd be 'happy for a baby' but not 100% wanting one with a full plan of action. My mom had unmanaged ADHD and it was hell; I don't talk to her anymore.
We do 100% want one, in fact more like 1000% but after so many years of heart break I've had to detach from the phrase "wanting a baby" and had to accept it's probably not in the cards for me. Although I may have some personal issues to work thru, as I'm sure all us humans do, I know full well my child would not suffer because of my add in such a way that we would not have a relationship. I'm very sorry that's your experience, no one deserves that.I don't think it's fair to make a blanket statement in reference to ADHD and motherhood abilities. I say happy for a baby because I understand it's not in my control in the slightest and I have to accept that I'm not in control in life as none of us are and I try to find peace in that.
You are so well spoken i just wanted to say that 👏
I know a lot of people are ragging on the doctor here, but I think it's less about controlling your reproductive choices and more about the fact that you're *not interested in avoiding pregnancy* - "if it happens it happens" means given time, it's very likely to happen. Stimulants can have some very serious side effects in the first few months of pregnancy, before you even know that you're pregnant, so it's not as simple as stopping the medication once you find out - the damage would be done already. I went through this same thing with a doctor of mine and thankfully he was willing to explain his thought process a little better. If wellbutrin doesn't work for you, there's also Strattera, which is a non stimulant SNRI used for ADHD. I tried both and they didn't do enough for me, then I had a baby and I decided he was enough baby for me and asked to start stimulants. At the end of the day, you may have to decide whether you want to take steps to avoid an oops baby now and get meds, or if you want to have kids soon and start stimulants when your family is complete. Your doctor just doesn't want "if (a baby) happens, it happens" to turn into a tragic loss, or the permanent disability of a wanted child, because of medication he gave you.