Winnie Titsworth

ADHD Medication During Pregnancy and Breastfeeding

Women with managing adhd without medication face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these medications can affect the foetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss 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 must weigh the benefits of taking them against potential risks to the foetus. Physicians don't have the data needed to make unequivocal recommendations however they can provide information regarding risks and benefits that help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy did not have a higher risk of fetal malformations, or structural birth defects. The researchers used a large population-based study of case-control to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was accurate and to eliminate any bias.

However, the researchers' study was not without its flaws. Researchers were unable in the beginning to differentiate the effects of the medication from the disorder. This makes it difficult for researchers to determine if the small differences observed between the exposed groups were due to medication use or confounded by the presence of comorbidities. Researchers also did not examine long-term outcomes for the offspring.

The study did reveal that babies whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or taken off their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission was not found to be affected by the type of stimulant medication was used during pregnancy.

Women who used stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean section or having a baby with a low Apgar score (less than 7). These increases did not seem to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the small risks associated with the use safest adhd medication for adults medications during early pregnancies can be offset by greater benefits for mother and baby from continuing treatment for the woman's condition. Doctors should discuss with their patients about this and, if possible, help them develop coping strategies that can lessen the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are taken in the absence of any evidence that is clear and definitive regardless, so doctors must weigh what they know, the experiences of other doctors, and what the research suggests on the subject and their best judgment for each patient.

The issue of possible risks to the infant can be extremely difficult. The research on this issue is based on observation rather than controlled studies and many of the findings are conflicting. The majority of studies focus on live births, which may underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing both information on deceased and live births.

Conclusion Some studies have shown an association between adhd Medication pregnancy medications and certain birth defects, other studies have not found a correlation. Most studies have shown that there is a neutral, or slightly negative, effect. In each case an in-depth analysis of the potential risks and benefits should be conducted.

For a lot of women with ADHD and ADD, the decision to stop medication is difficult if not impossible. In a recent article published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of being isolated. A decrease in medication could also impact the ability to safely drive and to perform work-related tasks which are crucial aspects of normal life for people with ADHD.

She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy educate family members, colleagues, and acquaintances about the condition, its impact on daily functioning and the benefits of continuing the current treatment plan. It can also help women feel more confident in her decision. It is important to note that certain drugs 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 transferred to the infant.

Birth Defects and Risk of

As the use and abuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing as does the concern about the possible effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of certain heart defects, like ventriculo-septal defects (VSD).

The authors of the study could not find any association between early medication usage and congenital anomalies such as facial deformities or club feet. The results are consistent with previous studies revealing an increase, but not significant, in the risk of heart malformations among women who started taking ADHD medications before pregnancy. The risk grew in the latter half of pregnancy, as many women begin to discontinue their medication.

Women who took get adhd medication online medication during the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after delivery, and have a baby who needed breathing assistance at birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could be a contributing factor to these findings.

The researchers hope their research will help inform the clinical decisions of physicians who treat pregnant women. They suggest that although the discussion of risks and benefits is important however, the decision to stop or continue medication must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors warn that, even though stopping the medication is an option to look into, it is not recommended due to the high prevalence of depression and other mental disorders for women who are pregnant or have recently given birth. Additionally, the research suggests that women who decide to stop taking their medication are more likely to have difficulties adjusting to life without them following the birth of their baby.

Nursing

The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments and preparing for the arrival of their child and getting used to new routines at home can experience severe challenges. Many women choose to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs are absorbed through breast milk in small amounts, so the risk to the infant who is breastfeeding is low. However, the rate of medication exposure to the infant can differ based on dosage, how often it is taken and at what time the medication is administered. 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 understood.

Due to the absence of research, some doctors may recommend stopping 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 possible risks to the fetus. In the meantime, until more information is available, GPs should ask all pregnant patients about their history of ADHD and whether they are planning or taking to take medication during the perinatal time.

A growing number of studies have proven that women can continue their ADHD medication while they are pregnant and nursing. In the end, many patients opt to do this and in consultation with their physician, they have discovered that the benefits of keeping their current medication far exceed any risk.

Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and reinforce strategies for coping. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.