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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these medications may affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication should consider the benefits of taking it versus the dangers for the baby. The doctors don't have the information to provide clear recommendations, but can provide information on the risks and benefits to aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large, population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was correct and to minimize any bias.

However, the researchers' study was not without its flaws. The researchers were not able in the beginning to distinguish the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to establish 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 the long-term effects for the offspring.

The study did reveal that infants whose mothers took ADHD medication 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 taken off their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean delivery or having a baby born with low Apgar score (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy.

The research suggests that the low risk associated with the use of ADHD medications used for adhd during early pregnancy may be offset by the higher benefit for both mother and child of continuing treatment for the woman's condition. Physicians should speak with their patients about this issue and try to 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 diagnosed with ADHD and being treated with medication, the issue of whether to continue or discontinue treatment during pregnancy is a question that doctors are having to have to face. Most of the time, these decisions are made in the absence of solid and reliable evidence in either case, which means that doctors must weigh their knowledge, the experiences of other doctors, and what the research says on the topic, along with their own judgments for each individual patient.

The issue of possible risks to infants is extremely difficult. The research on this subject is based on observation rather than controlled studies and many of the findings are in conflict. Additionally, the majority of studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues by analyzing both data on live and deceased births.

Conclusion A few studies have shown an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown a neutral, or even slightly negative, effect. In the end, a careful risk/benefit assessment must be done in each instance.

For women suffering from add adhd medications who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In fact, in a recent article in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness and family conflict for those suffering from the disorder. A decrease in medication could also impact the ability to safely drive and perform work-related tasks, which are vital aspects of daily life for those with ADHD.

She suggests that women who are unsure about whether to continue or discontinue medication due to their pregnancy should consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the advantages of staying on the current treatment plan. In addition, educating them can help the woman feel supported as she struggles with her decision. Some medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug may be transferred to her baby.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases, so does concern about the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Researchers utilized two massive data sets to study more than 4.3 million pregnancy and determine if the use of stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.

The researchers of the study found no connection between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in the same vein as previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the time of pregnancy. This risk increased during the latter stages of pregnancy when a large number of women stopped taking their medication.

Women who were taking ADHD medication in the first trimester were more likely need a caesarean and also have an insufficient Apgar after delivery, and have a baby who needed breathing assistance when they were born. The researchers of the study could not eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings.

Researchers hope their research will help doctors when they meet pregnant women. The researchers suggest that while discussing the risks and benefits are crucial, the decision regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and her needs.

The authors also advise that while discontinuing the medications is an option, it is not an option that is recommended due to the high incidence of depression and other mental health issues for women who are expecting or post-partum. Research has also shown that women who can prescribe medication for adhd (Https://qooh.me) stop taking their medications will have a harder transitioning to life without them once the baby is born.

Nursing

It can be overwhelming becoming a mother. Women suffering from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The risk to a breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk at a low level. However, the frequency of exposure to medication by the newborn may differ based on dosage, how often it is taken and at what medications are prescribed for adhd time it is administered. Additionally, different drugs enter the infant's system via the gastrointestinal tract, or through breast milk. The effect on a newborn's health is not completely comprehended.

Because of the lack of evidence, some doctors might be tempted to stop taking stimulant medications during a woman's pregnancy. This is a difficult decision for the patient, who must balance the benefits of keeping her medication against the potential dangers to the fetus. In the meantime, until more information is available, GPs may inquire about pregnant patients if they have any history of ADHD or if they plan to take medication during the perinatal phase.

A growing number of studies have shown that most women can safely continue taking their ADHD medication during pregnancy and while breastfeeding. 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 continuing their current medication far exceed any risk.

Women who suffer from ADHD who are planning to nurse should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the underlying disorder, learn about available treatments and to reinforce existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.