ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these drugs may affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication should consider the benefits of taking it versus the dangers for the foetus. Physicians do not have the data needed to provide clear recommendations, but they can provide information on benefits and risks that can aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy did not have a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to assess the frequency of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to ensure that the classification was accurate and to minimize any bias.
The research conducted by the researchers was not without limitations. The researchers were not able in the beginning, to separate the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the groups exposed were due to the use of medication, or if they were confounded by comorbidities. The researchers also did not examine long-term outcomes for offspring.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without 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 affected by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases did not appear to be affected by the type of medication that was used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this and try to help them develop coping skills that may reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or end treatment during pregnancy is a question that more and more physicians have to face. Often, these decisions are taken in the absence of solid and reliable evidence either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what the research says on the topic, along with their own judgments for each patient.
Particularly, the subject of potential risks for the infant can be difficult. The research that has been conducted on this topic is based on observation rather than controlled studies and many of the findings are contradictory. The majority of studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.
The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship, and most studies show a neutral or even slight negative effect. Therefore, a careful risk/benefit analysis must be done in each case.
For women suffering from ADHD who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In an article published in the 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 patients with ADHD. A decrease in medication could affect the ability to drive safely and complete work-related tasks, which are vital aspects of everyday life for those suffering from ADHD.
She suggests that women who are unsure whether to take the medication or discontinue it due to pregnancy educate family members, coworkers, and acquaintances about the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. In addition, educating them can aid in ensuring that the woman feels supported as she struggles with her decision. It is also worth noting that some medications are able to be absorbed through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug could be transferred to the child.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. With two massive data sets researchers were able examine more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.
The researchers of the study could not discover any link between the use of early medications and congenital anomalies like facial deformities, or club feet. The results are in the same vein as previous studies that have shown an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication before the birth of their child. The risk increased in the latter half of pregnancy when a large number of women decided to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely to need a caesarean or have a low Apgar after delivery and have a baby who needed breathing assistance after birth. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who didn't have any other medical issues that could have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of physicians who encounter pregnant women. They suggest that although the discussion of the benefits and risks is important however, the decision to stop or continue treatment must be based on each woman's needs and the severity of her ADHD symptoms.
The authors caution that, although stopping the medication is a possibility to think about, it isn't advised due to the high rate depression and other mental disorders in women who are expecting or who have recently given birth. Additionally, the research suggests that women who decide to stop taking their medications are more likely to have difficulties getting used to life without them after the baby's arrival.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women with ADHD who have to manage their symptoms while attending physician appointments, making preparations for the arrival of a baby and adjusting to new household routines can experience severe challenges. Many women choose to continue taking their ADHD medication during pregnancy.
click the up coming website page to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk at low levels. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and the time of day. In addition, different medications enter the baby’s system through the gastrointestinal tract or through breast milk. The impact on a newborn's health is not fully understood.
Because of the lack of research, some physicians may be inclined to discontinue stimulant drugs during a woman's pregnancy. This is a difficult choice for the patient, who must balance the benefits of keeping her medication against the possible dangers to the foetus. Until more information becomes available, GPs may inquire about pregnant patients if they have a background of ADHD or if they plan to take medication during the perinatal stage.
A increasing number of studies have shown that women can continue taking their ADHD medication during pregnancy and breastfeeding. In response, an increasing number of patients are opting to do this. They have discovered after consulting with their doctor, that the benefits of retaining their current medication far outweigh any potential risks.
Women with ADHD who are planning to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. adhd medication side effects should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help pregnant people with ADHD be aware of their symptoms and the underlying disorder and learn about treatment options and reinforce existing coping strategies. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration and, if necessary, adjustments to the medication regimen.