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 are few data on how exposure to ADHD for a long time could affect a fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have the information needed to provide clear recommendations, but they can provide information regarding benefits and risks that can aid pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face an increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based study of case control to examine the prevalence of major structural defects in infants born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to confirm that the classification was correct and to minimize any bias.

However, the researchers' study was not without its flaws. Researchers were unable in the beginning, to separate the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the few associations observed between the groups that were exposed to medication use or confounded by co-morbidities. Additionally the study did not look at 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 were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication that was used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.

Researchers suggest that the minor risks associated with the use ADHD medications in early pregnancies can be offset by more beneficial outcomes for both baby and mother of continued treatment for the woman’s disorder. Physicians should discuss this with their patients and, if possible, assist them in developing strategies to improve coping skills which can reduce the negative impact of her condition on her daily life and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to keep treatment or stop as more women are diagnosed with adhd Medication pregnancy, notabug.org,. These decisions are often taken without clear and authoritative evidence. Instead, doctors have to consider their own expertise and experience, as well as the experiences of other physicians and the research on the topic.

The issue of potential risks for infants can be particularly tricky. The research on this issue is based on observations rather than controlled studies, and a lot of the results are contradictory. The majority of studies limit their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.

Conclusion Some studies have found a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies show an unintended, or slight negative effect. Therefore, a careful risk/benefit analysis must be done in each case.

For many women with ADHD, the decision to discontinue 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 being isolated. In addition, a decrease in medication can interfere with the ability to do jobs and drive safely which are essential aspects of a normal life for many people suffering from ADHD.

She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers, and their friends about the condition, its impact on daily functioning and the benefits of continuing the current treatment plan. Educating them can also make the woman feel more comfortable when she is struggling with her decision. Certain medications can pass through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication could be passed on to her baby.

Risk of Birth Defects

As the use and abuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the potential effects of these drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Using two massive data sets researchers were able look at 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 overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.

The authors of the study did not 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 cardiac malformations for women who began taking ADHD medication before the birth of their child. The risk increased in the latter stages of pregnancy when a large number of women decided to stop taking their medication.

Women who were taking ADHD medication during the first trimester were more likely to require a caesarean delivery, have an insufficient Apgar after delivery and have a baby who needed help breathing after birth. The researchers of the study were not able to eliminate bias due to selection because they limited their study to women without other medical conditions that could have contributed to the findings.

Researchers hope that their research will provide doctors with information when they see pregnant women. They advise that while the discussion of the benefits and risks is important however, the decision to stop or continue treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also advise that while discontinuing the medications is an option, it is not an option that is recommended due to the high incidence of depression and other mental health issues for women who are expecting or postpartum. 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 that come with being a new mother can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant medicines pass through breast milk in small quantities, so the risk to the infant who is breastfeeding is low. However, the amount of exposure to medications by the infant can differ based on dosage, frequency it is administered, and at what time the medication is administered. Additionally, different drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The effect on a newborn's health is not fully understood.

Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman, who must weigh the advantages of continuing her medication against the risks to the fetus. Until more information becomes available, doctors can ask pregnant patients whether they have a history of ADHD or if they plan to take medication in the perinatal phase.

A increasing number of studies have revealed that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are opting to continue their medication. They have concluded after consulting with their doctors, that the benefits of retaining their current medication outweigh any possible risks.

It is essential for women with ADHD who are considering breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and strengthen coping mechanisms. This should be a multidisciplinary effort together with obstetricians, GPs and psychiatry. 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 types of adhd medication uk deterioration and when necessary, making adjustments to the medication regimen.