ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is challenging for women with the condition. There isn't much information on how long-term exposure to these drugs may affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to evaluate the benefits of using it versus the risks to the foetus. Physicians do not have the necessary data to give clear guidelines however they can provide information on risks and benefits that assist pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. The researchers used a large population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to confirm that the classification was accurate and to eliminate any bias.
However, the researchers' study had its limitations. The researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. That limitation makes it difficult to determine whether the small associations observed in the exposed groups result from medication use or confounding by comorbidities. Additionally the study did not examine the long-term effects of offspring on their parents.
The study showed that infants whose mother took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers didn't take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies can be offset by greater benefits for mother and baby of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve coping skills that can lessen the impact of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether or not to discontinue treatment during pregnancy is one that more and more doctors confront. These decisions are frequently made without clear and authoritative evidence. Instead, physicians must take into account their own experience, the experience of other doctors and the research on the subject.
Particularly, the subject of potential risks to the baby can be a challenge. Many studies on this issue are based on observational evidence rather than controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which could undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings, by examining both information on deceased and live births.
Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. Most studies have shown that there is a neutral, or slight negative impact. In all cases an in-depth evaluation of the risks and benefits must be performed.
For many women with ADHD who suffer from ADHD, the decision to stop taking medication can be difficult, if not impossible. In a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for patients with ADHD. In addition, a decrease in medication can affect the ability to perform jobs and drive safely, which are important aspects of a normal life for a lot of people with ADHD.
She recommends that women who are unsure about whether or not to stop medication in light of their pregnancy, consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily life, and the benefits of keeping the current treatment plan. It can also help a woman feel supported in her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be transferred to the baby.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two huge datasets to analyze over 4.3 million pregnant women and determine whether stimulant medications increased birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects such as ventriculo-septal defect (VSD).
The researchers of the study could not discover any connection between early use of medication and other congenital anomalies, such as facial deformities or club feet. The results are in the same vein as previous studies that showed an insignificant, but small increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. The risk increased in the latter half of pregnancy when a large number of women stopped taking their medication.
Women who used ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby who needed breathing assistance during birth. The researchers of the study could not eliminate bias due to selection because they restricted 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 important, the decision about whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also caution that, while stopping the medication is an option, it is not an option that is recommended due to the high prevalence of depression and other mental health issues among women who are pregnant or who are recently postpartum. Further, the research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them after the birth of their baby.
Nursing
The responsibilities of being a new mom can be overwhelming. Women with ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to a new routine. As such, many women elect to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines are absorbed through breast milk in very small quantities, so the risk to breastfeeding infant is minimal. However, the amount of exposure to medication by the infant can differ based on the dosage, frequency it is administered and the time of day it is administered. Additionally, different medications are introduced into the baby's system via the gastrointestinal tract or breast milk. The impact on the health of a newborn is not fully understood.
Some doctors may stop taking stimulant medication during a woman's pregnancy due to the lack of research. This is a difficult decision for the mother, who must weigh the benefits of taking her medication as well as the potential risks to the foetus. In adhd medication list , until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and whether they are taking or planning to take medication during the perinatal time.
A growing number of studies have revealed that women can continue their ADHD medication while they are pregnant and nursing. In the end, an increasing number of patients choose to do so and, in consultation with their doctor they have discovered that the benefits of maintaining their current medication exceed any risk.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior 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 is also required to help women with ADHD recognize their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for managing. This should include an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.