10 Best Mobile Apps For ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how exposure to ADHD for a long time could affect a pregnant fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to weigh the benefits of taking it versus the risks for the foetus. Physicians don't have the data to give clear advice however they 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 their early pregnancy were not at a greater risk of fetal malformations or structural birth defects. Researchers used a vast, population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure correct case classification and to minimize the possibility of bias.
However, the study was not without its flaws. Researchers were unable, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small differences observed between the groups exposed were due to the use of medication or if they were confounded by the presence of comorbidities. The researchers also did not look at long-term outcomes for the offspring.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefit to both the mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, when possible, help them develop strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships.
look at this site are increasingly confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must consider their own expertise, the experience of other doctors, and the research on the subject.
The issue of possible risks to infants is particularly tricky. The research on this issue is based on observation rather than controlled studies and a lot of the results are in conflict. The majority of studies focus on live births, which can underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study presented in the journal club addresses these shortcomings by analyzing information on deceased and live births.
Conclusion A few studies have found an association between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show an unintended, or slightly negative, impact. In the end, a careful risk/benefit analysis must be conducted in every situation.
For a lot of women with ADHD and ADD, the decision to discontinue medication is difficult, if not impossible. In fact, in an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness, and family conflict for patients with ADHD. A loss of medication may affect the ability to safely drive and perform work-related tasks, which are crucial aspects of daily life for people with ADHD.
She recommends women who are unsure about whether or not to discontinue medication due to their pregnancy consider educating family members, friends, and coworkers on the condition, its effects on daily functioning, and the advantages of continuing the current treatment regimen. It will also help a woman feel supported in her decision. It is important to note that certain medications are able to be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the medication could be transferred to the child.
Birth Defects Risk
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about the effects that the medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.
The researchers of the study found no association between the use of early medications and other congenital abnormalities, like facial clefting, or club foot. The results are in line with previous studies revealing an increase, but not significant, in the risk of developing cardiac malformations among women who started taking ADHD medications prior to the time of pregnancy. This risk increased during the latter part of pregnancy when many women decided to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean delivery and also have an insufficient Apgar after delivery, and have a baby who needed breathing assistance at birth. The authors of the study were unable to eliminate bias due to selection because they restricted the study to women without other medical conditions that might have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of physicians who encounter pregnant women. They advise that while the discussion of risks and benefits is important however, the decision to stop or maintain medication should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also caution that while discontinuing the medications is an option, it is not an option that is recommended due to the high rate of depression and other mental health issues among women who are pregnant or who are recently postpartum. Additionally, research suggests that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.
Nursing
The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments as well as preparing for the arrival of a baby and adjusting to new household routines may face a lot of challenges. This is why many women decide to continue taking their ADHD medications throughout the course of pregnancy.
The majority of stimulant medicines are absorbed through breast milk in low amounts, so the risk to the infant who is breastfeeding is low. The rate of medication exposure will vary based on the dosage, frequency of administration and the time of day. In addition, different medications enter the baby’s system via the gastrointestinal tract or breast milk. The effect on the health of a newborn isn't completely understood.
Because of the lack of research, some physicians might be tempted to stop taking stimulant drugs during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the risk to the embryo. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time.
A increasing number of studies have shown that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are choosing to do so. They have concluded through consultation with their physicians that the benefits of continuing their current medication far outweigh any possible risks.
Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help women with ADHD be aware of their symptoms and underlying disorder and learn about treatment options and reinforce existing strategies for managing. This should be a multidisciplinary effort including obstetricians, GPs and psychiatry. Pregnancy counselling should include discussion of a management plan for both the mother as well as the child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.