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 aren't many studies on how long-term exposure may affect a foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of taking them against potential risks to the fetus. Doctors don't have the necessary data to make unequivocal recommendations but they can provide information on benefits and risks that can assist pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast, population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants in the early stages of pregnancy and those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure 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 to, in the first place, to separate the effects caused by the medication from the disorder. This 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 look at the long-term effects of offspring on their parents.
The study revealed that babies whose mothers took ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy or had stopped taking their medication before or during pregnancy. This increase was caused by 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 also had an increased risk of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These increases did not appear to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies can be offset by greater benefits to both mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, when possible, assist them in developing strategies to improve their coping abilities that may minimize the effects of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the issue of whether or not to discontinue treatment during pregnancy is one that more and more doctors have to face. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge in conjunction with the experiences of other physicians and the research on the subject.
The issue of possible risks for infants can be particularly tricky. Many studies on this subject are based on observational data instead of controlled research and their conclusions are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study presented in the journal club addresses these issues by analyzing both data on live and deceased births.
Conclusion: While some studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown an unintended, or slightly negative, impact. Therefore, a careful risk/benefit analysis must be conducted in every situation.
It 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 loneliness. A loss of medication may affect the ability to drive safely and perform work-related tasks, which are essential aspects of normal life for people with ADHD.
She recommends women who are uncertain about whether to continue or discontinue medication due to their pregnancy should consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the advantages of continuing the current treatment regimen. It will also help a woman feel confident about her decision. It is important to remember that some drugs can 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 child.
Birth Defects and Risk of
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns over the impact that these medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects such as ventriculo-septal defect (VSD).
The researchers behind the study found no association between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in line with previous studies that have shown the presence of a small, but significant increase in the risk of cardiac malformations in women who started taking ADHD medications before the time of pregnancy. The risk grew in the latter half of pregnancy, when many women are forced to stop taking their medication.
Women who took ADHD medications in the first trimester of pregnancy were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who required help breathing at birth. However the authors of the study were not able to eliminate selection bias by restricting the study to women who did not have other medical issues that could have contributed to the findings.
More Signup bonuses hope that their research will help doctors when they meet pregnant women. They recommend that, while a discussion of risks and benefits is important however, the decision to stop or keep medication must be based on each woman's requirements and the severity of her ADHD symptoms.
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 for women who are pregnant or recently gave birth. Further, research shows that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to new routines. Therefore, many women decide to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines pass through breast milk in low quantities, so the risk for infant who is breastfeeding is low. However, the frequency of exposure to medication by the infant can differ based on the dosage, frequency it is administered and the time of day the medication is administered. In addition, different drugs enter the infant's system via the gastrointestinal tract or through breast milk. The effect on the health of a newborn isn't completely understood.
Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the woman, who must weigh the advantages of taking her medication as well as the risks to the foetus. Until more information becomes available, GPs may inquire about pregnant patients if they have any background of ADHD or if they plan to take medication during the perinatal stage.
Numerous studies have proven that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, a growing number of patients are opting to continue their medication. They have discovered, in consultation with their doctor that the benefits of keeping their current medication outweigh risk.
click for source 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 doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD be aware of their symptoms and underlying disorder, learn about available treatment options and reinforce existing coping strategies. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if necessary adjustments to the medication regimen.