ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these medications can affect the foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to weigh the benefits of taking it against the potential risks for the baby. Physicians don't have the data to provide clear recommendations however they can i get adhd meds without a diagnosis provide information on the risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face an higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a massive population-based case control study to assess the frequency of major structural defects in infants born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was accurate and to eliminate any bias.
However, the researchers' study had its limitations. The researchers were unable to, in the first place to distinguish the effects triggered by the medication for adhd and anxiety in adults from the disorder. This limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to the use of medication or confounding by comorbidities. Researchers also did not look at long-term outcomes for the offspring.
The study revealed that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system-related disorders and the increased risk of admission was not found to be affected by the type of stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits to both the mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this and try to help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is one that doctors are having to have to face. Often, these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh what they know, the experiences of other doctors, and what the research says on the topic and their best adhd medication for adults with anxiety and depression judgment for each patient.
Particularly, the issue of possible risks to the baby can be tricky. A lot of studies on this topic are based on observational data instead of controlled research and their conclusions are often contradictory. Most studies limit their analysis to live births, which can underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study discussed in this journal club addresses these issues by examining data on both live and deceased births.
The conclusion: While some studies have found an association between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link and the majority of studies show a neutral or even slight negative effect. In all cases, a careful analysis of the risks and benefits is required.
It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of loneliness. Furthermore, a loss of medication can affect the ability to do work-related tasks and safely drive, which are important aspects of a normal life for a lot of people with ADHD.
She suggests that women who are unsure whether to take the medication or stop it due to their pregnancy, educate their family members, colleagues, and their friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment regimen. It will also help a woman feel more confident in her decision. It is important to note that some medications can pass through the placenta, so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be transferred to the child.
Risk of Birth Defects
As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the potential adverse effects of the drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers utilized two massive data sets to examine over 4.3 million pregnancies and determine if the use of stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increased risk of specific heart defects, such as ventriculo-septal defect (VSD).
The authors of the study found no link between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in the same vein as previous studies that 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 birth of their child. The risk increased in the latter half of pregnancy when many women decided to stop taking their medication.
Women who used getting adhd medication uk (visit the following website page) medications in the first trimester of pregnancy were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby that required breathing assistance at birth. However, the authors of the study were not able 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 the findings.
The researchers hope their study will help inform the clinical decisions of physicians who treat pregnant women. They recommend that, while the discussion of the benefits and risks is important however, the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also caution that even though stopping the medication is an option, it isn't a recommended practice because of the high incidence of depression and other mental health issues among women who are pregnant or who are recently post-partum. Research has also shown that women who stop taking their medications will have a difficult transitioning to life without them after the baby is born.
Nursing
The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant drugs pass through breast milk in small quantities, so the risk to infant who is breastfeeding is low. However, the rate of medication exposure to the infant can differ based on dosage, how often it is administered, and at what time the medication is administered. In addition, different drugs enter the infant's system via the gastrointestinal tract or breast milk. The effect on the health of a newborn isn't fully comprehended.
Because of the lack of research, some doctors may recommend stopping stimulant medications during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the advantages of her medication against the risks to the foetus. As long as more information is available, GPs can ask pregnant patients if they have any background of ADHD or if they are planning to take medication during the perinatal period.
A increasing number of studies have shown that most women can safely continue taking their ADHD medication while they are pregnant and nursing. This has led to more and more patients choose to do so and in consultation with their physician, they have discovered that the benefits of keeping their current medication far outweigh any risks.
Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should include an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include the discussion of a plan for management for both the mother as well as the child, as well as monitoring for signs of deterioration and the need for adjustments to the medication regimen.