Three Greatest Moments In ADHD Medication Pregnancy History
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these drugs may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the benefits of using them against the risks to the fetus. The doctors don't have the information to give clear advice however they can provide information on risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during early pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to reduce any bias.
However, the study was not without its flaws. In particular, they were unable to distinguish the effects of the medication from the effects of the disorder that is underlying. This limitation makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to the use of medications or caused by the presence of comorbidities. Additionally, the researchers did not study long-term offspring outcomes.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child from continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when they are able, assist them in developing strategies for improving their coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the dilemma of whether to continue or discontinue treatment during pregnancy is one that doctors are having to have to face. These decisions are often made without clear and reliable evidence. Instead, physicians must weigh their own knowledge, the experience of other physicians and the research that has been conducted on the subject.
Particularly, the subject of potential risks to the baby can be a challenge. Many studies on this subject are based on observational data rather than controlled research and their findings are often contradictory. In addition, most studies limit their analysis to live births, which may underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study presented in the journal club addresses these issues, by examining both information on deceased and live births.
The conclusion: While some studies have shown a positive association between ADHD medications and the risk of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slightly negative impact. Therefore an accurate risk-benefit analysis must be conducted in every situation.
For many women with ADHD and ADD, the decision to stop taking medication is difficult, if not impossible. In a recent article published in 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. A loss of medication may affect the ability to safely drive and complete work-related tasks, which are vital aspects of everyday life for people with ADHD.
She suggests that women who are not sure whether to continue taking the medication or stop due to pregnancy, educate their family members, coworkers and friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment. It can also help women feel supported in her decision. Certain medications can be passed through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could be passed on to her infant.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about what impact the drugs could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Using two massive data sets researchers were able to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medicines was associated with an increased risk of specific heart defects, like ventriculo-septal defects (VSD).
The researchers of the study didn't 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 cardiac malformations in women who started taking ADHD medications prior to the birth of their child. The risk grew in the later part of pregnancy, when many women begin to discontinue their ADHD medications.
Women who were taking ADHD medication during the first trimester were more likely to need a caesarean or have a low Apgar after birth and have a baby that needed help breathing when they were born. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who did not have any other medical issues that could have contributed to the findings.
The researchers hope their study will help inform the clinical decisions of physicians who treat pregnant women. medications for adhd uk recommend that, while discussing risks and benefits is important but the decision to stop or maintain treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also advise that, while stopping the medication is an alternative, 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, the research suggests that women who choose to stop taking their medications are more likely to have a difficult time getting used to life without them following the baby's arrival.
Nursing
It can be overwhelming to become a mother. Women who suffer from ADHD are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to new routines. This is why many women choose to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small quantities, so the risk for breastfeeding infant is minimal. However, the rate of exposure to medication by the newborn may differ based on the dosage, frequency it is administered, and the time of the day it is administered. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract, or through breast milk. The effect on a newborn's health is not completely understood.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication with the potential dangers to the foetus. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal time.
Many studies have shown that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. This has led to more and more patients are choosing to do so and after consulting with their doctor, they have discovered that the benefits of keeping their current medication far outweigh any potential risks.
It is essential for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and build strategies for coping. This should include a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. 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, if necessary, adjustments to the medication regimen.