ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data on how long-term exposure may affect a pregnant fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are required.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to evaluate the benefits of using it against the possible risks for the baby. Physicians don't have the necessary data to provide clear recommendations however they can provide information on risks and benefits that aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers used a large population-based case control study to examine the prevalence of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to confirm that the classification was correct and to reduce any bias.
The research conducted by the researchers was not without its limitations. The researchers were unable in the beginning, to separate the effects caused by the medication from the disorder. That limitation makes it difficult to determine whether the small associations observed in the exposed groups are due to medication use or confounding by comorbidities. The researchers also did not look at long-term outcomes for offspring.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medication was used during pregnancy.
adhd and medication who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean birth or having a baby born with an low Apgar score (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits for both mother and child of continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies to improve their coping abilities that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether to continue or discontinue treatment during pregnancy is a question that more and more doctors have to face. The majority of these decisions are made in the absence of clear and authoritative evidence regardless, so doctors have to weigh their experience, the experiences of other doctors, and what research suggests about the subject and their best judgment for each individual patient.
The issue of potential risks to infants is particularly tricky. The research that has been conducted on this topic is based on observation rather than controlled studies and the results are 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 that is discussed in this journal club addresses these issues by looking at data from both live and deceased births.
Conclusion A few studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. The majority of studies show a neutral, or even slight negative effect. In each case an in-depth evaluation of the benefits and risks must be performed.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In an article published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation and family conflict for those suffering from the disorder. Furthermore, a loss of medication can interfere with the ability to complete jobs and drive safely that are crucial aspects of daily life for many people with ADHD.
She suggests that women who are not sure whether to continue taking medication or stop due to pregnancy should educate family members, coworkers, and acquaintances about the condition, the effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to note that some medications can pass through the placenta, therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug could be passed on to the baby.
Birth Defects and Risk of
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about the effects that the drugs could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers used two huge data sets to examine over 4.3 million pregnant women and determine if the use of stimulant medications caused birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication use was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
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 line with previous studies which showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of the time of pregnancy. This risk increased during the latter half of pregnancy when a large number of women decided to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to need a caesarean, have a low Apgar after birth and have a baby that needed breathing assistance when they were born. However, the authors of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have other medical issues that could have contributed to the findings.
The researchers hope their research will serve to inform the clinical decisions of physicians who encounter pregnant women. They advise that while the discussion of the risks and benefits is crucial however, the decision to stop or continue treatment should be based on the woman's requirements and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is a possibility to look into, it is not advised due to the high rate depression and mental health issues in women who are expecting or have recently given birth. Further, research shows that women who stop taking their medications will have a difficult time adjusting to a life without them after the baby is born.
Nursing
The responsibilities of being a new mother can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments and preparing for the arrival of their child and adjusting to new household routines are often faced with a number of difficulties. adult adhd medication is why many women decide to continue taking their ADHD medications throughout pregnancy.
The risk to a breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk at a low level. The rate of medication exposure will vary based on the dosage, frequency of administration and the time of the day. In addition, 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 might be tempted to stop taking stimulant medications during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the potential risks to the embryo. In the meantime, until more information is available, doctors can inquire about pregnant patients whether they have an history of ADHD or if they are planning to take medication during the perinatal phase.
Numerous studies have demonstrated that women can continue to take their ADHD medication without risk while breastfeeding and during pregnancy. In adhd and medication , an increasing number of patients are opting to continue their medication. They have discovered after consulting with their doctors, that the benefits of keeping their current medication outweigh any potential risks.
It's important for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and strengthen the coping mechanisms. This should involve a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both the mother as well as the child, as well as monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.