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Psychostimulants may help opioid use disorder (OUD) outcomes in pregnant women, according to a study published online June 11 in Nature Mental Health.
Kevin Y. Xu, M.D., M.P.H., from the Washington University School of Medicine in St. Louis, and colleagues used U.S. multistate administrative data to examine the risks and benefits of attention-deficit/hyperactivity disorder (ADHD) medication among 3,247 pregnant women initiating OUD treatment, with 5 percent receiving psychostimulants.
The researchers found that compared to peers not receiving psychostimulants, individuals receiving psychostimulants had greater buprenorphine (adjusted relative risk, 1.81) but lower methadone initiation (adjusted relative risk, 0.39). Among psychostimulant recipients who initiated buprenorphine, lower buprenorphine discontinuation was seen among those receiving psychostimulants versus nonrecipients (adjusted hazard ratio, 0.77). Person-days (defined by psychostimulant fills) were associated with fewer substance use disorder-related admissions versus days without fills in within-person case-crossover analyses (odds ratio, 0.50).
“These findings highlight important potential benefits of pharmacologically treating ADHD with stimulants in pregnant people with concomitant OUD and ADHD,” the authors write. “Future studies are warranted to clarify pregnancy and neonatal outcomes when treating this specific population to further inform share decision-making.”
One author disclosed ties to the pharmaceutical industry.
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