Acetaminophen / Paracetamol – Not safe during Pregnancy after all?

This wasn’t really the news we wanted to hear.  After all that women with headache have to deal with during pregnancy – now there’s doubt about just how safe Tylenol is.

A study published in JAMA Pediatrics in February studied the link between acetaminophen / paracetamol and behaviour problems linked to attention-deficit/hyperactivity disorder (ADHD).

The study used telephone interviews during pregnancy and 6 months after, and then the follow-up 7 years later.

The researchers found that use of acetaminophen / paracetamol did increase the risk of ADHD.  They also discovered that if the mother used the drug during more than one trimester, the risk increased.  If more Tylenol was taken, the risk also increased.

On one level this is very discouraging news with anyone with chronic headache, who may be taking acetaminophen /paracetamol more than a few times over nine months.  It also demonstrates that there may be “subtle” issues that are not studied yet – side effects for the baby that we don’t even yet understand – that this and other drugs may be causing.

Every medication comes with risk.  We need to do our best to weigh the risk and benefit.  Although many of the risks are simply unknown, in the modern age of powerful computers we can expect to see more risks like these come to light as studies become more sophisticated.

On another level, however, this may not be as big an issue for many mothers.  For those with migraine, Tylenol is likely not the best choice anyway, and may be very little help.  More complete targeted treatment, including non-drug treatments, can be a great help to pregnant women.

Of course that doesn’t mean we’re getting away from risk – just this risk.  But it does mean that there may be treatments that are effective enough that the woman can take fewer drugs, and have less pain during pregnancy.

Dr. Alexander Mauskop has some thoughts on this study and treatment during pregnancy here.  Read the abstract on the study at Acetaminophen Use During Pregnancy, Behavioral Problems, and Hyperkinetic Disorders.  See also Can Pregnant Migraineurs Take Drugs?