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ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medication during pregnancy and nursing is challenging for women with the condition. Little data exists about how long-term exposure to these drugs can affect the foetus.

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

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against potential risks to the foetus. Physicians don't have the information needed to give clear guidelines but they can provide information regarding the risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at higher risk of fetal malformations, or structural birth defects. Researchers used a large sample-based case control study to examine the prevalence of major structural defects in infants who were born to mothers who took stimulants during pregnancy. 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 study had its limitations. most popular adhd medication important, they were unable to distinguish the effects of the medication from the effects of the disorder at hand. This makes it difficult to know whether the small associations observed in the groups that were exposed result from medication use or comorbidities that cause confusion. Researchers also did not examine the long-term effects for the offspring.

The study did reveal that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or stopped their medications before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean birth or having a child with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefits for both mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships.

Interactions with Medication

Many doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of any evidence that is clear and definitive regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what research suggests about the subject as well as their own judgments for each patient.

Particularly, the subject of possible risks to the baby can be tricky. Many of the studies on this subject are based on observational evidence rather than controlled research, and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing both information on deceased and live births.

The conclusion is that while certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link, and most studies have a neutral or slightly negative effect. As a result, a careful risk/benefit analysis is required in every instance.

It isn't easy, but not impossible for women suffering from ADHD to stop taking their medication. In an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for these patients. The loss of medication can also affect the ability to safely drive and complete work-related tasks, which are vital aspects of everyday life for those suffering from ADHD.

She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily functioning, and on the advantages of continuing the current treatment regimen. It can also help a woman feel more confident in her decision. It is also worth noting that some drugs can pass through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the medication could be transferred to the child.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about what impact the drugs could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two huge data sets to study over 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Researchers found that while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.

The researchers of the study didn't discover any link between early use of medication and other congenital anomalies like facial deformities or club feet. The results are in line with previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. The risk was higher in the latter half of pregnancy, when a lot of women decide to stop taking their ADHD medication.

Women who prescribes medication for adhd took ADHD medications in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby that required help breathing at birth. The authors of the study were unable to remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.

The researchers hope their research will aid in the clinical decisions of doctors who treat pregnant women. They recommend that, while the discussion of the risks and benefits is crucial however, the decision to stop or maintain medication should be based on the woman's needs and the severity of her adhd and medication symptoms.

The authors caution that, although stopping the medication is a possibility to consider, it is not recommended due to the high rate depression and other mental problems for women who are pregnant or have recently given birth. Further, the research suggests that women who decide to stop taking their medications are more likely to have difficulties adjusting to life without them following the birth of their baby.

Nursing

It can be overwhelming becoming a mother. Women with ADHD who must work through their symptoms while attending physician appointments as well as preparing for the arrival of their child and adapting to new routines in the home are often faced with a number of difficulties. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy.

The risk for nursing infant is low because the majority of stimulant medication passes through breast milk in low amounts. The amount of exposure to medications can vary depending upon the dosage and frequency of administration as well as the time of day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn isn't fully understood.

Some doctors may stop taking stimulant medication during a woman's pregnancy due to the lack of research. This is a complicated decision for the patient, who must balance the benefits of keeping her medication against the potential risks to the embryo. Until more information becomes available, doctors may inquire about pregnant patients if they have a history of ADHD or if they intend to take medication during the perinatal period.

Numerous studies have proven that women can continue to take their ADHD medication without risk during pregnancy and breast-feeding. As a result, an increasing number of patients opt to do this and after consulting with their doctor, they have found that the benefits of keeping their current medication outweigh any potential risks.

Women with adhd medication and pregnancy uk who can prescribe medication for adhd are planning to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women with adhd and depression medication be aware of the symptoms and the underlying disorder. They should also be educated about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary process including obstetricians, GPs, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of indicators of deterioration, and, if needed modifications to the medication regimen.