ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There is
medication adhd adults of information about how long-term exposure to these drugs could affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the advantages of taking them against potential risks to the fetus. Physicians do not have the information needed to make unequivocal recommendations however they can provide information on benefits and risks that can assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to ensure that the classification was correct and to eliminate any bias.
However, the researchers' study had its limitations. Researchers were unable in the beginning to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine if the small associations observed among the groups that were exposed to medication use or if they were affected by comorbidities. The researchers also did not examine long-term outcomes for the offspring.
The study revealed that babies whose mothers took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a baby born with a low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication 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 could be offset by the higher benefit to both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them develop coping strategies that may reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether to keep or stop treatment during pregnancy is one that doctors are having to have to face. These decisions are often made without clear and reliable evidence. Instead, doctors have to weigh their own knowledge in conjunction with the experiences of other doctors, and the research that has been conducted on the subject.
Particularly,
medication adhd adults of possible risks to the baby can be tricky. Many of the studies on this topic are based on observational evidence instead of controlled research and their findings are often contradictory. The majority of studies focus on live births, which may underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these issues by analyzing data on live and deceased births.
Conclusion: While some studies have shown an association between ADHD medications and certain birth defects However, other studies haven't found a correlation. The majority of studies show a neutral, or even somewhat negative, impact. As a result, a careful risk/benefit assessment is required in every case.
For many women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In a recent piece 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 loneliness. A decrease in medication could also affect the ability to safely drive and perform work-related tasks, which are crucial aspects of normal life for those with ADHD.
She suggests that women who aren't sure whether to continue taking the medication or stop it due to their pregnancy, educate their family members, colleagues, and acquaintances about the condition, the effects on daily functioning, and the benefits of keeping the current treatment regimen. It will also help a woman feel more confident in her decision. Certain medications can be passed through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could be transferred to the infant.
Birth Defects Risk
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about the effects that the medications could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Researchers used two massive data sets to study more than 4.3 million pregnant women and determine if the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects, like ventriculo-septal defects (VSD).
The researchers of the study could not discover any connection between early medication usage and congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the time of pregnancy. This risk increased during the latter half of pregnancy, when a lot of women decided to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely need a caesarean or have a low Apgar after delivery, and have a baby who needed breathing assistance at birth. The researchers of the study were not able to remove bias in selection since they restricted the study to women without other medical conditions that might have contributed to the findings.
Researchers hope that their research will provide doctors with information when they see pregnant women. They recommend that, while the discussion of the benefits and risks is important but the decision to stop or keep treatment should be based on the woman's requirements and the severity of her ADHD symptoms.
The authors caution that, although stopping the medication is a possibility to consider, it is not recommended due to the high prevalence of depression and mental health issues for women who are pregnant or who have recently given birth. Research has also shown that women who stop taking their medication will have a difficult transitioning to life without them once the baby is born.
Nursing
It can be a stressful experience to become a mother. Women who suffer from ADHD may face a lot of challenges when they have to manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.
medication for add adults of stimulant medicines are absorbed by breast milk in small quantities, so the risk to the nursing infant is very low. The rate of medication exposure will vary based on the dosage the medication is administered, its frequency and the time of day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not fully known.
Because of the lack of research, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. This is a difficult decision for the patient, who must balance the benefits of keeping her medication against the potential dangers to the foetus. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal period.
A growing number of studies have revealed that the majority of women are able to safely continue their ADHD medication during pregnancy and breastfeeding. In response, a rising number of patients are opting to do so. They have found, in consultation with their physicians that the benefits of keeping their current medication outweigh risk.
It is essential for women with ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological methods. 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 strengthen the coping mechanisms. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration, and, if necessary modifications to the medication regime.