The Three Greatest Moments In ADHD Medication Pregnancy History
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There isn't much information on how long-term exposure to these drugs could affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication should consider the benefits of taking it against the possible dangers for the baby. Doctors don't have the necessary data to provide clear recommendations but they can provide information about risks and benefits that aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not have a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a massive population-based study of case control to compare the incidence of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was correct and to minimize any bias.
The study of the researchers was not without limitations. The researchers were not able, in the first place, to separate the effects caused by the medication from the disorder. This limitation makes it difficult to know whether the small associations observed in the groups that were exposed result from medication use or confounding by comorbidities. Additionally the study did not examine long-term offspring outcomes.
The study found that infants whose mothers had taken ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy or quit taking the medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit for both mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, where they are able, assist them in developing strategies for improving their coping skills which can reduce the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests about the subject, along with their own best judgment for each patient.
The issue of risk for infants can be extremely difficult. Many studies on this topic are based on observational evidence rather than controlled research, and their conclusions are often contradictory. In addition, most 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 discussed in the journal club addresses these limitations by analyzing the data from deceased and live births.
The conclusion The conclusion: While certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, other studies have found no such relationship, and most studies show a neutral or even slight negative effect. In the end an accurate risk-benefit analysis is required in every situation.
adult add medications can be challenging, if not impossible for women with ADHD to stop taking their medication. 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. Furthermore, a loss of medication may affect the ability to complete work-related tasks and safely drive which are essential aspects of a normal life for many people suffering from ADHD.
She suggests that women who are not sure whether to take the medication or stop it due to their pregnancy should educate family members, coworkers, and friends about the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. It can also help a woman feel supported in her decision. Certain medications can pass through the placenta. If the patient decides not to take her ADHD medication while breastfeeding, it is important to be aware that 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) increases as do concerns about the effects that the medications could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Researchers used two huge data sets to examine over 4.3 million pregnancy and determine if the use of stimulant medications caused birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects, such as ventriculo-septal defect (VSD).
The authors of the study could not discover any connection between the use of early medications and other congenital anomalies, such as facial deformities or club feet. The results are in line with previous studies that have shown a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of the birth of their child. This risk increased during the latter stages of pregnancy, when a lot of women began to stop taking their medication.
Women who took ADHD medication in the first trimester of pregnancy were also more likely to experience caesarean sections, a low Apgar score after delivery and a baby who required help breathing at birth. The researchers of the study were unable to eliminate bias due to selection because they limited the study to women with no other medical conditions that could have contributed to the findings.
Researchers hope that their study will help doctors when they meet pregnant women. The researchers recommend that, while discussing benefits and risks are important, the choice about whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and her requirements.
The authors warn that, even though stopping the medication is a possibility to consider, it is not advised due to the high prevalence of depression and other mental disorders among women who are pregnant or have recently given birth. Further, the research suggests that women who decide to stop taking their medications are more likely to experience difficulties adjusting to life without them after the baby's arrival.
Nursing
The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments as well as making preparations for the arrival of a child and adapting to new routines in the home are often faced with a number of difficulties. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at low levels. However, the frequency of exposure to medication by the newborn can vary depending on dosage, frequency it is administered and the time of day it is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn infant is not yet fully known.
Due to the absence of evidence, some doctors may recommend stopping stimulant medication during the pregnancy of a woman. It is a difficult decision for the mother, who must weigh the benefits of her medication against the risk to the embryo. Until more information becomes available, doctors may ask pregnant patients if they have an background of ADHD or if they intend to take medication in the perinatal stage.
A growing number of studies have proven that women can continue taking their ADHD medication during pregnancy and breastfeeding. In response, a rising number of patients are choosing to continue their medication. They have found through consultation with their physicians, that the benefits of continuing their current medication outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help women with ADHD understand their symptoms and underlying disorder, learn about available treatment options and strengthen existing coping strategies. 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 when necessary, making adjustments to the medication regimen.