The No. #1 Question Everybody Working In ADHD Medication Pregnancy Should Be Able To Answer
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how long-term exposure to these medications can affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication must evaluate the benefits of using it against the possible risks to the fetus. Physicians do not have the necessary data to make unequivocal recommendations but they can provide information regarding the risks and benefits to assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate classification of the cases and to reduce the possibility of bias.
The research conducted by the researchers was not without its limitations. The researchers were unable in the beginning, to separate the effects triggered by the medication from the disorder. This makes it difficult for researchers to establish whether the small associations observed among the groups exposed were due to medication use or confounded by comorbidities. Additionally the study did not study the long-term outcomes of offspring.
The study revealed that infants whose mother took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system-related 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 medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases did not appear to be influenced by the kind of medication used during pregnancy.
Researchers suggest that the minor risk of using ADHD medications during early pregnancies can be offset by more beneficial outcomes for both mother and baby of continuing treatment for the woman's condition. Physicians should discuss this with their patients and, if possible, help them develop strategies for improving their coping skills that can lessen the impact of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the dilemma of whether or not to end treatment during pregnancy is one that more and more doctors have to face. Most of the time, these decisions are taken in the absence of clear and authoritative evidence either way, so physicians must weigh their knowledge from their own experiences, those of other doctors, and what research suggests on the subject, along with their own best judgment for each patient.
The issue of potential risks to infants is extremely difficult. The research on this subject is based on observations instead of controlled studies and a lot of the results are in conflict. Additionally, the majority of studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these shortcomings, by examining both data on live and deceased births.
Conclusion: While some studies have shown an association between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies have shown a neutral, or even slightly negative, effect. In the end an accurate risk-benefit analysis is required in every situation.
For many women with ADHD who suffer from ADHD, the decision to stop taking 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 lead to depression and feelings of loneliness. Additionally, the loss of medication can interfere with the ability to do jobs and drive safely which are essential aspects of daily life for many people with ADHD.
She suggests that women who are not sure whether to continue taking the medication or discontinue it due to pregnancy, educate their family members, coworkers, and their friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment plan. It can also aid in ensuring that the woman feels supported in her struggle with her decision. It is also worth noting that some medications are able to be absorbed 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 drug can be passed on to the baby.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. With two massive data sets, researchers were able to look at more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk 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, such as facial clefting or club foot. The results are in the same vein as previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before pregnancy. The risk grew in the later part of pregnancy, when a lot of women decide to stop taking their ADHD medication.
Women who took ADHD medication in the first trimester were more likely to require a caesarean delivery and also have a low Apgar after birth and had a baby that required help breathing at birth. The authors of the study were not able to remove bias in selection since they limited the study to women who did not have any other medical conditions that might have contributed to the findings.
Researchers hope that their study will provide doctors with information when they encounter pregnant women. The researchers recommend that, while discussing the risks and benefits are crucial, the decision regarding whether or not to stop medication should be based on the severity of each woman's ADHD symptoms and her requirements.
The authors warn that, although stopping the medication is a possibility to consider, it is not recommended due to the high rate depression and mental health issues among women who are pregnant or have recently given birth. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience difficulties getting used to life without them after the baby's arrival.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women with ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. This is why many women decide to continue taking their ADHD medications throughout pregnancy.
adhd depression medication of stimulant drugs are absorbed by breast milk in very small amounts, therefore the risk to infant who is breastfeeding is low. The amount of exposure to medications will vary based on the dosage the medication is administered, its frequency and the time of day. In addition, various medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The effect on the health of a newborn isn't fully understood.
Because of the lack of evidence, some doctors may recommend stopping stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefits of continuing her medication against the potential risks to the foetus. In the meantime, until more information is available, doctors may inquire about pregnant patients whether they have a background of ADHD or if they intend to take medication during the perinatal stage.
A increasing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. In the end, many patients opt to do this, and in consultation with their physician, they have discovered that the benefits of keeping their current medication exceed any risk.
It is essential for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women with ADHD recognize the signs and underlying disorder. They should also be educated about treatment options and reinforce strategies for coping. This should be a multidisciplinary approach including obstetricians, GPs and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother as well as the child, as well as monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.