10 Quick Tips About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data regarding how exposure over time may affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to adhd uk medication medication in utero do not develop neurological disorders such as impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians don't have the data to make unambiguous recommendations but they can provide information on risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to assess the frequency of major structural defects in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was correct and to reduce any bias.
The study conducted by the researchers was not without limitations. The most important issue was that they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This makes it difficult for researchers to determine if the small associations observed among the exposed groups were due to the use of medication or if they were confounded by co-morbidities. Additionally the study did not study long-term offspring outcomes.
The study did reveal that babies whose mothers had taken ADHD medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or had cut back on their medications 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 medication used during pregnancy.
Women who used stimulant adhd medication options medication during pregnancy were also at an elevated risk of having a caesarean delivery or having a baby born with a low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications in early pregnancies could be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman's condition. Doctors should discuss with their patients about this issue and try to help them develop coping skills that can lessen 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 question of whether to continue or end treatment during pregnancy is a question that more and more physicians have to face. These decisions are often made without clear and reliable evidence. Instead, physicians must weigh their own knowledge, the experience of other doctors and the research that has been conducted on the subject.
The issue of potential risks to the infant can be particularly tricky. The research on this subject is based on observation rather than controlled studies, and the results are contradictory. Most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link and the majority of studies have a neutral or slightly negative impact. In the end, a careful risk/benefit analysis must be done in each instance.
For many women with adhd medication making It Worse, the decision to discontinue medication is difficult, if not impossible. In fact, in a recent article in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness and family conflict for patients with ADHD. A decrease in medication could also affect the ability to drive safely and complete work-related tasks, which are essential aspects of daily life for those with ADHD.
She recommends women who are uncertain about whether or not to stop medication in light of their pregnancy consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and the advantages of continuing the current treatment plan. It can also aid in ensuring that the woman feels supported as she struggles with her decision. It is also worth noting that certain drugs can be absorbed through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug 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 there are concerns about the effects that the drugs might have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers used two huge data sets to examine over 4.3 million pregnant women and determine if the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.
The authors of the study did not discover any link between early use of medication and congenital anomalies like facial deformities, or club feet. The findings are in line with previous studies that have shown the presence of a small, but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to pregnancy. This risk increased during the latter half of pregnancy when many women stopped taking their medication.
Women who took safest adhd medication medication in the first trimester of pregnancy were also more likely to experience caesarean section, low Apgar score after delivery and a baby who needed help breathing at birth. The researchers of the study were not able to eliminate selection bias because they limited their study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope that their research will help inform the clinical decisions of physicians who encounter pregnant women. The researchers advise that, while discussing benefits and risks are important, the decision about whether to continue or stop medication should be in light of the severity of each woman's ADHD symptoms and her needs.
The authors also advise that even though stopping the medication is an option, it is not a recommended practice because of the high rate of depression and other mental health issues for women who are expecting or who are recently postpartum. Further, research shows 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 becoming a mother. Women with ADHD who must work through their symptoms while attending physician appointments as well as making preparations for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. This is why many women decide to continue taking their ADHD medication throughout the pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. The rate of medication exposure can vary depending upon the dosage, frequency of administration and time of day. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn infant is not well understood.
Some doctors may stop taking stimulant medications 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 foetus. Until more information becomes available, GPs can inquire about pregnant patients whether they have a history of ADHD or if they are planning to take medication in the perinatal phase.
Numerous studies have demonstrated that women can continue to take their safest adhd medication medication safely during pregnancy and breast-feeding. In response, a rising number of patients are opting to do so. They have discovered through consultation with their doctor that the benefits of retaining their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD be aware of their symptoms and the root cause and learn about treatment options and reinforce existing strategies for coping. This should be a multidisciplinary process with the GPs, obstetricians, and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.