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ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and nursing is a difficult decision for women suffering from the condition. There aren't many studies on how long-term exposure may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss 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 taking ADHD medication should weigh the benefits of taking it against the possible dangers for the baby. Doctors don't have the information needed to provide clear recommendations but they can provide information regarding the risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large population-based case control study to compare the incidence of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate case classification and to minimize the chance of bias.
However, the researchers' study had its limitations. Researchers were unable in the beginning to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine whether the small associations observed among the groups that were exposed to the use of medication, or if they were confounded by co-morbidities. In addition the researchers did not examine the long-term outcomes of offspring.
The study did reveal that babies whose mothers had taken ADHD medication during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean section or having a baby born with low Apgar score (less than 7). These risks did not appear to be affected by the type of medication that was used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications in early pregnancies can be offset by more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them improve coping skills which could reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of solid and reliable evidence in either case, which means that doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests on the subject as well as their own best judgment for each individual patient.
Particularly, the subject of potential risks to the infant can be difficult. Many studies on this topic are based on observational data rather than controlled research, and their findings are often contradictory. Most studies limit their analysis to live births, which may underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing information on deceased and live births.
The conclusion is that 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 slightly negative impact. Therefore an accurate risk-benefit analysis must be conducted in every instance.
For many women with ADHD who suffer from ADHD, the decision to stop medication is difficult, if not impossible. In fact, in a recent article 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 these patients. In addition, a decrease in medication can affect the ability to complete job-related tasks and drive safely which are essential aspects of daily life for many people suffering from ADHD.
She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy, educate their family members, coworkers, and acquaintances about the condition, the impact on daily functioning and the benefits of keeping the current treatment plan. It can also help a woman feel more confident in her decision. It is important to note that certain medications are able to pass through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the medication could be transferred to the infant.
Birth Defects and Risk of
As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases, so does concern about the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. medication for adhd uk utilized two massive data sets to study over 4.3 million pregnant women and determine if the use of 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 increased risk of certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study didn't discover any connection between the use of early medications and other congenital anomalies, like facial deformities or club feet. The results are in agreement with previous studies which showed a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of pregnancy. The risk grew in the latter half of pregnancy, as many women are forced to stop taking their ADHD medications.
Women who took ADHD medications during the first trimester of their pregnancies were also more likely to experience a caesarean section, a low Apgar score after delivery and a baby who required help breathing at birth. The researchers of the study were not able to remove bias in selection since they restricted the study to women with no other medical conditions that could have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of doctors who encounter pregnant women. They suggest that although a discussion of risks and benefits is important, the decision to stop or maintain medication should be based on each woman's needs and the severity of her ADHD symptoms.
The authors caution that, although stopping the medication is a possibility to consider, it is not advised because of the high incidence of depression and mental health issues in women who are expecting or have recently given birth. Further, the research suggests that women who choose to stop their medications are more likely to have a difficult time getting used to life without them after the birth of their baby.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD who must work through their symptoms while attending physician appointments and making preparations for the arrival of their child and adjusting to new household routines may face a lot of challenges. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to nursing infant is low because the majority of stimulant medication passes through breast milk in low amounts. The rate of exposure to medication will vary based on the dosage the medication is administered, its frequency and the time of day. In addition, various drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't completely understood.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the lack of research. It is a difficult decision for the woman who must weigh the advantages of her medication against the potential risks to the foetus. Until more information becomes available, doctors may ask pregnant patients whether they have a background of ADHD or if they are planning to take medication in the perinatal period.
A increasing number of studies have proven that women can continue to take their ADHD medication during pregnancy and breastfeeding. This has led to many patients choose to do so, and in consultation with their doctor they have discovered that the benefits of maintaining their current medication far exceed any risk.
Women with ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help women with ADHD understand their symptoms and the underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should involve a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, monitoring of signs of deterioration and, if necessary adjustments to the medication regimen.