ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data regarding how exposure over time may affect a pregnant fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological disorders like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the advantages of taking them against potential risks to the foetus. Doctors don't have the information needed to give clear guidelines, but they can provide information regarding risks and benefits that help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a massive sample-based case control study to compare the incidence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure correct case classification and to minimize the chance of bias.
adhd treatment without medication conducted by the researchers had some limitations. The most important issue was that they were not able to differentiate the effects of the medication from the effects of the disorder that is underlying. This makes it difficult to know whether the limited associations observed in the exposed groups are due to the use of medication or comorbidities that cause confusion. In addition, the researchers did not look at long-term offspring outcomes.
The study did find that infants whose mothers took ADHD medications during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had cut back on their medications prior to or during pregnancy. The reason for this was central nervous system-related disorders and the increased risk of admission was not found to be influenced by the stimulant medication was used during pregnancy.
adhd medication for adults uk who took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean delivery or having a child with a low Apgar score (less than 7). These increases didn't seem to be influenced by the type of medication that was used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit for both mother and child of continuing treatment for the woman's disorder. Doctors should discuss with their patients about this and, if possible, help them develop coping strategies that can lessen the impact of her disorder in her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to keep or end treatment during pregnancy is one that more and more physicians face. These decisions are frequently made without clear and authoritative evidence. Instead, doctors have to take into account their own experience, the experience of other physicians and the research on the topic.
Particularly, the subject of potential risks for the infant can be difficult. A lot of studies on this issue are based on observational data rather than controlled research, and their conclusions are often contradictory. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by looking at data from both live and deceased births.
Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects However, other studies haven't found a correlation. The majority of studies show that there is a neutral, or slightly negative, impact. In each case it is imperative to conduct a thorough study of the risks and benefits should be conducted.
For a lot of women with ADHD, the decision to stop taking medication is difficult if not impossible. In a recent article published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of being isolated. Additionally, the loss of medication can affect the ability to perform work-related tasks and safely drive that are crucial aspects of daily life for many people with ADHD.
best adhd medication suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy should educate family members, coworkers and their friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment plan. It can also help women feel confident about her decision. Some medications can pass through the placenta. If a woman decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be passed on to her baby.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about what impact the medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers used two massive data sets to examine over 4.3 million pregnancy and determine if the use of stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The researchers of the study could not find any association between early medication usage and other congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that showed a small, but significant increase in cardiac malformations for 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 began to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth or have an insufficient Apgar after birth and have a baby who needed breathing assistance after birth. The authors of the study could not eliminate selection bias because they limited the study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of doctors who see pregnant women. The researchers advise that, while discussing the risks and benefits are important, the decision regarding whether or not to stop medication should be according to the severity of each woman's ADHD symptoms and her requirements.
The authors also caution that, while stopping the medication is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health problems among women who are pregnant or postpartum. Research has also shown that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.
Nursing
The responsibilities of a new mother can be overwhelming. Women with ADHD are often faced with a number of difficulties when they have to manage 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 risk to breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk in low amounts. The rate of exposure to medication will differ based on dosage, frequency of administration and time of day. In addition, different drugs enter the infant's system via the gastrointestinal tract or breast milk. The effect on a newborn's health is not fully known.
Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the absence of research. This is a complicated decision for the patient, who must weigh the benefits of continuing her medication with the potential dangers to the foetus. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal time.
A increasing number of studies have shown that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. This has led to an increasing number of patients are choosing to do so, and in consultation with their doctor they have discovered that the benefits of maintaining their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary process together with obstetricians, GPs and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, monitoring of signs of deterioration and, if needed adjustments to the medication regimen.