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Can Tylenol Use During Pregnancy be Linked to ADHD?

For many years, Tylenol, also known as acetaminophen, has been considered safe for pregnant women to use for mild pain relief. New research indicates that exposure to acetaminophen while in utero may significantly increase a child’s risk of developing Attention-Deficit/Hyperactivity Disorder, as well as other neurodevelopmental conditions. The makers of acetaminophen drugs, including Johnson & Johnson and retailers such as Walmart, are being sued by plaintiffs who say that these companies had a responsibility to provide warning labels on their products. 

Plaintiffs in these lawsuits are seeking compensation for the financial and emotional impact their child’s ADHD has had on their families. If your child has been diagnosed with ADHD after exposure to acetaminophen in utero, it is in your best interest to contact a qualified personal injury lawyer to explore your options for compensation. The Tylenol ADHD lawyers of Dolman Law Group are available to discuss your case and explain the process of filing a personal injury claim in a free consultation.

How Can a Tylenol ADHD Lawyer Help Me?

Choosing to hire a Tylenol ADHD attorney can help ensure that you receive a fair settlement for your damages, as a personal injury lawyer will have the expertise that is critical to maximizing compensation. They offer a variety of services, including leading the negotiation process, handling communication with other parties, and managing administrative responsibilities. 

In terms of negotiating your settlement, a personal injury lawyer will calculate the value of your damages and then construct a strategy to obtain a settlement as close to that value as possible. They are familiar with the tactics defendants employ to undermine claims and avoid paying their full value, so they will be able to anticipate and avoid these attacks. Meanwhile, they will keep the administrative side of the claims process running smoothly to ensure that critical deadlines are met.

Another benefit to hiring a personal injury lawyer is that they will become your representative not only to the defendants’ team but to other parties like bill collectors and the media as well. Mass tort cases involving ubiquitous and trusted products like Tylenol have the potential to attract significant media attention. Having a Tylenol ADHD lawyer who is capable of navigating the media while dealing with the demands of the formal claims process can be a highly valuable asset. 

What is Attention-Deficit/Hyperactivity Disorder?

Attention-Deficit/Hyperactivity Disorder is a chronic mental health disorder that affects millions of children and adults across the U.S. Common features of ADHD include difficulty paying attention, constant fidgeting, and making rash decisions or acting on impulse. It should be noted that ADHD may manifest differently based on gender and age. 

There are three types of ADHD. Children with the hyperactive-impulsive presentation of ADHD tend to have high energy levels, difficulty staying on task or sitting still, and make decisions with no regard for potential outcomes. This is the stereotypical idea of what it means to have ADHD, and as a result, other forms are more commonly overlooked or dismissed.

The second way that ADHD can appear is in an inattentive presentation. Children with an inattentive presentation of ADHD may tend to daydream, make careless mistakes, and procrastinate their tasks. Finally, a child with a combined presentation will likely display characteristics of both hyperactivity and inattentiveness. ADHD usually lasts into adulthood, and without treatment, it can interfere with academic and professional achievement, as well as personal relationships.

How is ADHD Diagnosed?

ADHD is formally diagnosed by providers such as psychologists, primary care providers, and psychiatrists, although it is often first noticed by teachers or parents. For a formal diagnosis, a provider will typically request a physical exam to rule out other conditions. Based on information collected from the patient, their parents, and other sources like teachers, the provider can consider if an ADHD diagnosis is appropriate. For example, the family’s medical history and the child’s environment can offer insight into the likelihood of their ADHD.

Risk Factors for ADHD:

  • Having parents or close family members with ADHD
  • Premature birth
  • Exposure to toxic chemicals or substances, like lead
  • Exposure to drugs, alcohol, or nicotine in utero

Identifying ADHD in Children

In order for an official diagnosis of ADHD to be made, there are several criteria that must be met. For children specifically, the following must apply:

  • Symptoms have been consistently displayed for 6 months or more
  • The onset of symptoms occurred before they were 12
  • Symptoms were present in multiple contexts, such as school and home
  • There is a meaningful impact on the child’s life, such as in their relationships or academic achievement
  • Symptoms are attributable to ADHD rather than other conditions or common comorbidities like anxiety

Once an ADHD diagnosis has been made, there are two primary treatment options. For children 6 and older, behavior therapy and medication may be used in combination to treat the symptoms of ADHD.

Systemic Analysis Links Acetaminophen Exposure In Utero to ADHD 

In 2018, researchers published a meta-analysis of multiple cohort studies in the American Journal of Epidemiology. They examined data from 132,738 mother-child pairs and the information provided by the original researchers’ follow-ups that took place 3 to 11 years after birth. The original studies differed in their methods for collecting their data, which may have some bearing on the results.

Based on their analysis, they determined that prenatal exposure to acetaminophen was associated with a 30% increased risk of ADHD and a 20% increased risk of autism. That said, they do note that the duration and timing of acetaminophen exposure did vary between mothers, and there are other potential confounding variables.

Specifically, they note that there may be confounding by indication bias. Pregnant women who are more prone to fevers and pain due to other conditions may take more Tylenol to treat their symptoms, and while this increases their fetus’ acetaminophen exposure, their other health issues may be the true cause of their child’s ADHD.

NIH Study On Prenatal Acetaminophen Exposure Finds Increased Risk of ADHD

Tylenol has long been considered a safe over-the-counter medication for the purposes of mild pain relief. However, a 2019 study conducted by the National Health Institute found an alarming connection between rates of ADHD and autism and children who had been significantly exposed to acetaminophen in utero.

NIH researchers analyzed data from the Boston Birth Cohort, which is an observational study that has collected information on healthy, full-term singleton children since 1998. There are 24,000 study participants, although the NIH study focused on data from 996 births. NIH researchers compared levels of acetaminophen from the umbilical cords of these 996 births and divided the children into 3 categories based on how much acetaminophen was detected. 

25% of the study participants had received an ADHD diagnosis by age 9. Nearly 7% had been diagnosed as autistic, and approximately 4% had been diagnosed with both conditions. The findings showed that the children who had the highest level of exposure to acetaminophen, as determined by the levels of acetaminophen and its byproducts in their umbilical cords, were at 2.86 times the risk for developing ADHD, and 3.62 times the risk for autism as compared to the children in the lowest third.

Study Supports Previous Findings Connecting Acetaminophen Use During Pregnancy to ADHD

A group of researchers published an article in the European Journal of Epidemiology in 2021 that evaluated data from 6 cohorts to determine if acetaminophen exposure was related to ADHD and autism. The researchers for each cohort had conducted interviews with the mothers within 18 months of delivery to determine the child’s prenatal and postnatal acetaminophen exposure. 

Researchers then collected information on ADHD or autism diagnoses when the children were between 4 and 12 years old. A total of 73,881 mother-child pairs were included in the study. The researchers’ conclusions support earlier findings that using acetaminophen during pregnancy can increase the risk of the child developing ADHD. 

The data from the 6 European cohorts demonstrated a 21% increased risk of developing ADHD in children who had been prenatally exposed to acetaminophen. Researchers did not find any correlation between post-natal exposure to acetaminophen and ADHD. Results were consistent amongst cohorts, even when they omitted the data of the largest cohort in a leave-one-out analysis.

What Damages Can I Recover in a Tylenol ADHD Lawsuit?

As a child with ADHD grows, they may require more support in the classroom, such as tutoring. They can suffer in social situations and develop self-esteem issues. As an adult, they may fail to achieve their potential because they cannot meet project deadlines or master details. The financial and emotional costs associated with ADHD can be burdensome for individuals and their families.

Types of Damages in a Personal Injury Lawsuit:

If plaintiffs in the Tylenol ADHD lawsuits are able to establish that acetaminophen drug makers like Johnson & Johnson, Walmart, and CVS are liable for their damages, they can recover compensation for these losses. While the court may decide to impose punitive damages on negligent drug makers, the focus of the plaintiff’s representatives will be on recovering compensation for what they have already lost and why they will continue to lose.

Compensatory damages provide injured parties with financial relief for their economic and non-economic damages. Economic damages refer to costs with a set price tag, while non-economic damages reimburse the injured party for their invisible and emotional losses. In order to ensure that you are properly accounting for all of the economic and non-economic damages in your claim, you should consult with a qualified personal injury lawyer about what your Tylenol ADHD claim is worth.

Examples of Damages in a Tylenol ADHD Lawsuit:

Status of the Tylenol ADHD Lawsuits

The Tylenol ADHD lawsuits faced an early challenge from one of the largest defendants named in the claims. Walmart, which sells its own brand of generic acetaminophen, argued that it followed FDA guidelines for its warning labels, and the FDA’s federal guidelines should supersede state-level requirements on the basis of the preemption principle.

However, Judge Denise Cote dismissed this preemption challenge in a court order (PDF) as the federal guidelines issued by the FDA did not prevent them from adding to the warning labels to include a notice about the risks of using Tylenol while pregnant. Representatives for Walmart have since appealed this decision, but the product liability claims have continued to move forward in the meantime.

After the Tylenol ADHD/autism lawsuits were consolidated into a multidistrict litigation, product liability lawyers sought leadership positions. Judge Cote appointed the applicants to various leadership positions and committees in November of 2022. She has also approved the use of a Short-Form complaint that will allow new plaintiffs to provide a condensed version of their claim.