ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications may affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological conditions like hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of taking them against the potential risks to the fetus. The doctors don't have the information to make unambiguous recommendations however they can provide information on risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers used a large population-based case control study to compare the incidence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to make sure that the classification was accurate and to minimize any bias.
However, the study was not without its flaws. The researchers were not able in the beginning, to separate the effects triggered by the medication from the disorder. This limitation makes it difficult to know whether the small associations observed in the exposed groups are due to medication use or confounding by comorbidities. Additionally, the researchers did not look at the long-term outcomes of offspring.
The study found that infants whose mother had taken ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers didn't take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child from continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies for improving their coping skills that may minimize the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the dilemma of whether to continue or end treatment during pregnancy is one that more and more physicians confront. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to take into account their own experience and experience, as well as the experiences of other physicians and the research on the topic.
Particularly, the issue of potential risks for the infant can be difficult. The research that has been conducted on this topic is based on observations rather than controlled studies and many of the findings are contradictory. Most studies limit their analysis to live births, which can underestimate the teratogenic impact that can lead to abortions or terminations of pregnancy. The study discussed in this journal club addresses these issues by looking at data from both live and deceased births.
Conclusion Some studies have revealed an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies show that there is a neutral, or slightly negative, impact. In all cases, a careful study of the potential risks and benefits is required.
For a lot of women with ADHD and ADD, the decision to discontinue medication is difficult, if not impossible. In a recent article published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of being isolated. Furthermore, a loss of medication may affect the ability to do jobs and drive safely which are essential aspects of daily life for a lot of people with ADHD.
She suggests women who are unsure about whether to keep or stop taking medication because of their pregnancy should consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily life, and the advantages of continuing the current treatment regimen. It can also help women feel supported in her decision. It is important to note that certain medications can be absorbed through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of check here the medication could be passed on to the baby.
Birth Defects and Risk of
As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Using two massive data sets researchers were able examine more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.
The authors of the study found no link between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in agreement with previous studies which showed the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of the birth of their child. This risk increased in the later part of pregnancy, when a lot of women decide to stop taking their ADHD medications.
Women who used ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance at birth. The researchers of the study were not able to eliminate selection bias because they restricted the study to women with no other medical conditions that might have contributed to the findings.
Researchers hope that their research will help doctors when they see pregnant women. The researchers recommend that, while discussing risks and benefits are important, the decision about whether to continue or stop taking medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also warn that even though stopping the medication is an option, it is not an option to consider due to the high rate of depression and other mental health issues for women who are expecting or who are recently postpartum. Further, research shows that women who stop taking their medications will have a harder time adjusting to a life without them once the baby is born.
Nursing
It can be a challenge becoming a mother. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments as well as getting ready for the arrival of their child and adjusting to new household routines may face a lot of challenges. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy.
The risk to a breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk in low amounts. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and time of day. In addition, different medications enter the baby’s system through the gastrointestinal tract or through breast milk. The impact on a newborn's health is not fully understood.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant drugs during a woman's pregnancy. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the possible dangers to the embryo. In the meantime, until more information is available, doctors can ask pregnant patients whether they have an background of ADHD or if they are planning to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, a growing number of patients are opting to do so. They have discovered through consultation with their doctor that the benefits of keeping their current medication far outweigh any risk.
Women with ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD understand their symptoms and underlying disorder Learn about the available treatment options and strengthen existing strategies for managing. This should include a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration, and, if necessary modifications to the medication regime.