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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these medications may affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders like hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the advantages of using them against the risks to the fetus. Physicians do not have the data needed to make unequivocal 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 in early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers used a large 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. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was correct and to reduce any bias.

The study of the researchers had some limitations. Researchers were unable, in the first place to distinguish the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine if the small differences observed between the groups that were exposed to the use of medication or if they were caused by the presence of comorbidities. The researchers also did not examine long-term outcomes for offspring.

The study did reveal that infants whose mothers took ADHD medication during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had cut back on their medications prior to or during pregnancy. This increase was due to central nervous system-related disorders and the increased risk for admission did not appear to be influenced by the stimulant medications were used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the minor risks associated with the use ADHD medication during pregnancies in the early stages may be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies for improving their coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. These decisions are frequently made without clear and reliable evidence. Instead, physicians must weigh their own knowledge in conjunction with the experiences of other doctors, and the research that has been conducted on the subject.

In particular, the issue of potential risks to the baby can be a challenge. Many of the studies on this topic are based on observations rather than controlled research, and their conclusions are often contradictory. The majority of studies focus on live births, which can underestimate the teratogenic impact that can lead to abortions or terminations of pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both information on deceased and live births.

Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown an unintended, or slightly negative, impact. In all cases it is imperative to conduct a thorough study of the potential risks and benefits should be conducted.

For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In an article recently 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 those suffering from the disorder. In addition, a decrease in medication may affect the ability to do work-related tasks and safely drive 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 due to pregnancy should educate family members, coworkers, and their friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment plan. It will also help a woman feel supported in her decision. It is important to note that certain drugs can pass through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be transferred to the infant.

Risk of Birth Defects

As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (adhd medication private prescription) increases the concern over the possible effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Using two massive data sets researchers were able analyze more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with a slightly higher rate of certain heart defects, such as ventriculo-septal defect (VSD).

The authors of the study didn't discover any connection between the use of early medications and other congenital anomalies like facial deformities or club feet. The results are in line with previous studies that have shown an increase, but not significant, in the risk of heart malformations among women who started taking ADHD medications prior to pregnancy. The risk increased in the latter stages of pregnancy when a large number of women stopped taking their medication.

Women who used ADHD medication in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score after delivery and a baby who needed breathing assistance during birth. However the authors of the study were not able to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could be a contributing factor to these findings.

The researchers hope that their research will help inform the clinical decisions Types Of adhd medication physicians who treat pregnant women. They recommend that, while the discussion of risks and benefits is important but the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms.

The authors warn that, even though stopping the medication is an option to think about, it isn't recommended because of the high incidence of depression and mental health issues for women who are pregnant or recently gave birth. Research has also shown that women who stop taking their medication will have a tough transitioning to life without them once the baby is born.

Nursing

It can be a stressful experience to become a mother. Women with ADHD who have to manage their symptoms while attending doctor appointments as well as making preparations for the arrival of a baby and adjusting to new household routines may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.

The risk for nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. The rate of exposure to medication will differ based on dosage the medication is administered, its frequency and the time of the day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn infant is not yet fully known.

Due to the absence of evidence, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. It is a difficult decision for the mother, who must weigh the benefits of her medication against the risk to the fetus. 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 period.

A growing number of studies have proven that most women can safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are opting to continue their medication. They have found through consultation with their doctors that the benefits of keeping their current medication outweigh possible risks.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help women with ADHD understand their symptoms and the root cause and learn about treatment options and reinforce existing coping strategies. This should be a multidisciplinary process with the GPs, obstetricians, and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, and monitoring for indicators of deterioration, and, if needed modifications to the medication regime.