10 Top Mobile Apps For ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these medications can affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality research is needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the foetus. Physicians don't have the data to make unambiguous recommendations but they can provide information on the risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers used a large sample-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was accurate and to reduce any bias.
However, the researchers' study was not without its flaws. Most important, they were not able to differentiate the effects of the medication from the effects of the underlying disorder. This makes it difficult to know whether the small differences observed in the exposed groups are due to the use of medication or comorbidities that cause confusion. In addition the researchers did not examine the long-term outcomes of offspring.
The study did show that infants whose mothers took ADHD medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system-related disorders, and the higher risk of admission did not appear to be influenced by which stimulant medication was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a child with low Apgar score (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits to both mother and child of continuing treatment for the woman's disorder. Doctors should discuss with their patients about this and as much as possible, assist them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh what they know, the experiences of other doctors, and what research suggests on the subject, along with their best judgment for each individual patient.
Particularly, the issue of potential risks to the baby can be tricky. A lot of studies on this issue are based on observational data rather than controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these shortcomings by looking at data from both live and deceased births.
Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't established a link. The majority of studies show an unintended, or slight negative impact. In every case it is imperative to conduct a thorough study of the potential risks and benefits must be performed.
For women suffering from ADHD and ADD, the decision to stop medication is difficult if not impossible. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of isolation. The loss of medication can affect the ability to drive safely and to perform work-related tasks which are crucial aspects of daily life for those suffering from ADHD.
managing adhd without medication suggests 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 life, and the advantages of continuing the current treatment regimen. It can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to remember that some medications can pass through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the medication could be transferred to the infant.
Risk of Birth Defects
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about the effects that the drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two huge datasets to analyze over 4.3 million pregnancies and determine whether stimulant medications caused birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The researchers behind the study found no connection between the use of early medications and congenital abnormalities like facial clefting, or club foot. The findings are in line with previous studies revealing an increase, but not significant, in the risk of developing cardiac malformations among women who began taking ADHD medications prior to the time of pregnancy. This risk increased in the later part of pregnancy, when many women begin to discontinue their ADHD medication.
Women who took ADHD medications during the first trimester of their pregnancies were also more likely to have a caesarean section, a low Apgar score following delivery, and a baby who required help breathing at birth. However, the authors of the study were not able to eliminate selection bias by limiting the study to women who did not have other medical issues that could have contributed to these findings.
Researchers hope that their research will provide doctors with information when they see pregnant women. The researchers advise that while discussing the risks and benefits are important, the choice regarding whether or not to stop medication should be according to the severity of each woman's ADHD symptoms and her needs.
The authors caution that, while stopping the medication is a possibility to think about, it isn't advised because of the high incidence of depression and mental health issues for women who are pregnant or have recently given birth. Additionally, research suggests that women who stop taking their medications will have a tough adjustment to life without them once the baby is born.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.
The majority of stimulant drugs pass through breast milk in low amounts, so the risk for infant who is breastfeeding is low. The rate of medication exposure can vary depending upon the dosage and frequency of administration as well as the time of the day. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The effect on a newborn's health is not fully comprehended.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant medication during a woman's pregnancy. This is a difficult decision for the woman, who must weigh the advantages of her medication against the potential risks to the embryo. As long as more information is available, doctors can inquire about pregnant patients if they have any history of ADHD or if they plan to take medication during the perinatal stage.
A growing number of studies have proven that the majority of women are able to safely continue their ADHD medication during pregnancy and while breastfeeding. This has led to an increasing number of patients are choosing to do so and, in consultation with their doctor they have found that the benefits of keeping their current medication exceed any risk.
Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help women with ADHD be aware of their symptoms and the underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should include a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.