10 Apps That Can Help You Control Your ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect the foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological conditions like impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the advantages of using them against the risks to the fetus. Physicians don't have the necessary data to give clear guidelines, but they can provide information on benefits and risks that can assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to limit the chance of bias.
The study conducted by the researchers was not without limitations. The most important issue was that they were unable to distinguish the effects of the medication from the disorder at hand. This limitation makes it difficult to know whether the small differences observed in the groups that were exposed result from medication use or the confounding effect of comorbidities. In addition the study did not look at the long-term effects of offspring on their parents.
The study found that infants whose mother had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a child with an low Apgar score (less than 7). These increases appear to be independent of the type of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both the mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, if they are able, assist them in developing strategies to improve their coping abilities which can reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. most effective adhd medication for adults I Am Psychiatry of these decisions are made without any evidence that is clear and definitive regardless, so doctors must weigh what they know from their own experiences, those of other doctors, and what research says on the topic, along with their own judgments for each patient.
Particularly, the issue of potential risks to the baby can be a challenge. The research that has been conducted on this topic is based on observation rather than controlled studies and many of the findings are in conflict. In addition, most studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues, by examining both data on live and deceased births.
The conclusion: While some studies have shown an association between ADHD medications and the possibility of certain birth defects, others have found no connection and the majority of studies have a neutral or slight negative effect. In each case, a careful analysis of the risks and benefits is required.
It can be challenging, if not impossible for women with ADHD to stop taking their medication. In fact, in a recent article in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for those suffering from the disorder. A loss of medication may also affect the ability to drive safely and complete work-related tasks, which are crucial aspects of normal life for those with ADHD.
She suggests women who are uncertain about whether to continue or stop medication in light of their pregnancy, consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily life, and the advantages of staying on the current treatment regimen. It will also help a woman feel more confident in her decision. Some medications can pass through the placenta. If a woman decides to not take her ADHD medication while breastfeeding, it is important to be aware that the medication may be transferred to her baby.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two massive datasets to analyze over 4.3 million pregnancy and determine whether stimulant medications caused birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects such as ventriculoseptal defect (VSD).
The researchers of the study did not find any association between early medication usage and other congenital anomalies like facial deformities or club feet. The results are in line with previous studies that showed a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the birth of their child. This risk increased in the latter half of pregnancy, as many women are forced to stop taking their ADHD medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean delivery, have an insufficient Apgar after birth and have a baby who needed help breathing when they were born. However the authors of the study were unable to eliminate selection bias by restricting the study to women who did not have any other medical issues that could have contributed to the findings.
Researchers hope that their research will provide doctors with information when they meet pregnant women. The researchers recommend that, while discussing benefits and risks are crucial, the decision on whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and her needs.
The authors warn that, while stopping the medication is a possibility to consider, it is not advised because of the high incidence of depression and mental health issues among women who are pregnant or recently gave birth. Further, the research suggests that women who choose to stop taking their medication are more likely to have difficulties getting used to life without them following the birth of their baby.
Nursing
It can be overwhelming becoming a mother. Women with ADHD are often faced with a number of difficulties when they have to manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at low levels. The amount of exposure to medications will differ based on dosage, frequency of administration and the time of the day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn is not yet fully known.
Due to the absence of research, some physicians may be inclined to discontinue stimulant medication during the course of pregnancy. It's a difficult choice for the woman who must weigh the benefits of her medication against the risk to the embryo. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and if they plan or are taking to take medication during the perinatal period.
Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. This has led to more and more patients opt to do this, and in consultation with their doctor they have found that the benefits of keeping their current medication far exceed any risk.
Women with ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary effort together with obstetricians, GPs and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of indicators of deterioration, and, if needed adjustments to the medication regime.