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 breast-feeding. There are few data regarding how exposure over time may affect a fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication should consider the benefits of taking it against the possible risks to the foetus. The doctors don't have the information to give clear advice, but can provide information on risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers conducted a large sample-based case control study to compare the incidence of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure correct classification of the cases and to reduce the chance of bias.
However, the researchers' study was not without its flaws. The most important issue was that they were unable to distinguish the effects of the medication from those of the underlying disorder. This makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to medication use or affected by co-morbidities. Researchers also did not study long-term outcomes for offspring.
The study found that babies whose mothers had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy or quit taking the medication prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission was not found to be influenced by which stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having a caesarean section or one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies could be offset by the greater benefits for mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, where possible, help them develop strategies to improve their coping abilities that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly confronted with the dilemma of whether to maintain treatment or stop as more women are diagnosed with ADHD. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other doctors and the research on the topic.
Particularly, the issue of potential risks for the baby can be a challenge. Many of the studies on this subject are based on observational data instead of controlled research and their conclusions are often contradictory. Most studies restrict their analysis to live births, which can underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study discussed in the journal club addresses these limitations by analyzing data on live and deceased births.
The conclusion: While certain studies have demonstrated an association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies show a neutral or even slight negative effect. In all cases, a careful evaluation of the benefits and risks is required.
For many women with ADHD, the decision to stop taking medication is difficult if not impossible. In an article published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation and family conflict for these patients. A decrease in medication could also impact the ability to safely drive and to perform work-related tasks which are essential aspects of everyday life for those suffering from ADHD.
She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy, educate their family members, coworkers, and friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment regimen. It can also help a woman feel confident about her decision. It is also worth noting that some medications are able to pass through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug could be passed on to the baby.
Birth Defects Risk
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows 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 huge datasets to analyze more than 4.3 million pregnant women and determine whether stimulant medications caused birth defects. While the overall risk remains low, the scientists discovered that the first-trimester exposure to ADHD medications was linked to a slightly higher rate of specific heart defects, like ventriculo-septal defects (VSD).
The authors of the study found no connection between early use of medication and other congenital anomalies, like facial clefting, or club foot. The results are in agreement with previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. This risk increased during the latter stages of pregnancy when many women decided to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean delivery or have an insufficient Apgar after delivery and have a baby that needed help breathing at birth. The authors of the study could not remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope their study will help inform the clinical decisions of physicians who treat pregnant women. how to treat adhd without medication in adults recommend that, while discussing benefits and risks 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 her needs.
The authors warn that, while stopping the medication is a possibility to look into, it is not advised due to the high rate depression and mental health issues among women who are pregnant or who have recently given birth. Additionally, research suggests that women who stop taking their medications will have a tough time adjusting to a life without them after the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. This is why many women elect to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed through breast milk in very small amounts, so the risk for nursing infant is very low. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and time of day. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not yet fully known.
Some doctors may stop taking stimulant medications during a woman's pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the potential risks to the foetus. As long as more information is available, GPs may ask pregnant patients if they have any background of ADHD or if they plan to take medication in the perinatal period.
A growing number of studies have shown that the majority of women are able to safely continue their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are choosing to continue their medication. They have found, in consultation with their doctor, that the benefits of retaining their current medication outweigh any potential risks.
Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and build coping mechanisms. This should be a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.