ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during pregnancy and breastfeeding is challenging for women with the condition. Little data exists about how long-term exposure to these drugs could affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or 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 need to consider the benefits of taking it versus the dangers for the fetus. The doctors don't have the information to provide clear recommendations however they can provide information about risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers used a vast, population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to ensure that the classification was accurate and to reduce any bias.
However, the researchers' study was not without its flaws. Researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine whether the small associations observed among the exposed groups were due to the use of medications or if they were confounded by comorbidities. The researchers did not look at long-term outcomes for the offspring.
The study did show that infants whose mothers took ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having to have a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases did appear to be independent of the type of medication used during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medications in early pregnancies can be offset by greater benefits for baby and mother of continued treatment for the woman's disorder. Physicians should talk to their patients about this issue and, if possible, help them improve coping skills which can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether or not to stop treatment during pregnancy is one that more and more physicians confront. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors must take into account their own experience, the experience of other doctors and the research that has been conducted on the subject.
Particularly, the subject of potential risks for the baby can be tricky. adult adhd medication that has been conducted on this topic is based on observations instead of controlled studies and many of the findings are in conflict. Furthermore, most studies restrict their analysis to live births, which can underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these issues by examining data on both live and deceased births.
The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative effect. In all cases, a careful evaluation of the risks and benefits should be conducted.
It can be challenging, if not impossible for women with ADHD to stop taking their medication. 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 patients with ADHD. A loss of medication may also affect the ability to drive safely and complete work-related tasks, which are crucial aspects of everyday life for those suffering from ADHD.
She suggests that women who are unsure whether to continue taking the medication or stop it due to their pregnancy, educate their family members, coworkers and acquaintances about the condition, its impact on daily functioning and the benefits of continuing the current treatment plan. It can also help the woman feel supported as she struggles with her decision. It is important to remember that certain medications can pass through the placenta, therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug can be passed on to the baby.
Birth Defects and Risk of
As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases, so does concern about the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers used two huge data sets to examine over 4.3 million pregnancies and determine if the use of stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The researchers behind the study found no link between early use of medication and other congenital anomalies, like facial clefting, or club foot. adhd medication uk are in line with previous studies revealing an increase, but not significant, in the risk of developing cardiac malformations among women who began taking ADHD medications before the birth of their child. This risk increased during the latter half of pregnancy when many women stopped taking their medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean birth and also have a low Apgar after delivery and had a baby that required breathing assistance when they were born. However, the authors of the study were unable to eliminate bias due to selection by restricting the study to women who didn't have any other medical conditions that could have contributed to these findings.
The researchers hope their study will serve to inform the clinical decisions of physicians who see pregnant women. The researchers advise that, while discussing risks and benefits are important, the decision on whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her requirements.
The authors also advise 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 issues among women who are pregnant or who are recently postpartum. Furthermore, research suggests that women who decide to stop taking their medication are more likely to experience a difficult time getting used to life without them following the birth of their baby.
Nursing
It can be overwhelming to become a mom. Women suffering from ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to new routines. 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. However, the frequency of exposure to medication by the infant can differ based on the dosage, frequency it is administered and the time of day the medication is administered. In addition, various medications are introduced into the baby's system through the gastrointestinal tract, or through breast milk. The impact on a newborn's health is not fully known.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication against the possible risks to the foetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they plan or are taking to take medication during the perinatal period.
Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and breast-feeding. As a result, many patients choose to do so and after consulting with their doctor, they have found that the benefits of continuing their current medication outweigh any potential risks.
It's important for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and build strategies for coping. This should be a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.