ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and breastfeeding is challenging for women with the condition. Little data exists about how long-term exposure to these drugs can general practitioners prescribe adhd medication affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against potential risks to the fetus. Physicians don't have the data to provide clear recommendations however they can provide information on risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy did not have a higher risk of fetal malformations, or structural birth defects. Researchers conducted a massive population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure an accurate case classification and to minimize the possibility of bias.
However, the researchers' study had its limitations. The most important issue was that they were not able to differentiate the effects of the medication from those of the disorder that is underlying. This limitation makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of medication or affected by co-morbidities. Additionally the study did not study long-term offspring outcomes.
The study did reveal that infants whose mothers took adhd medication Without diagnosis uk medications during pregnancy were at slightly greater 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-related disorders, and the increased risk for admission was not found to be influenced by the stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies can be offset by greater benefits for mother and baby of continuing treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them develop coping skills that may 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 treated with medication, the question cost of adhd medication uk whether to continue or end treatment during pregnancy is a question that doctors are having to confront. Most of the time, these decisions are taken in the absence of any evidence that is clear and definitive in either case, which means that doctors must weigh what they know, the experiences of other doctors, and what research says on the topic as well as their best medication for anxiety depression and adhd judgment for each individual patient.
In particular, the issue of possible risks to the baby can be a challenge. Many studies on this issue are based on observational evidence rather than controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which could underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues by analyzing both information on deceased and live births.
Conclusion: While some studies have found an association between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies have shown a neutral, or even slight negative effect. In all cases it is imperative to conduct a thorough evaluation of the risks and benefits must be performed.
It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In fact, in an article 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. Furthermore, a loss of medication can affect the ability to do work-related tasks and safely drive which are essential aspects of daily life for many people with ADHD.
She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy, educate their family members, coworkers, and friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment. Educating them can also make the woman feel more comfortable in her struggle with her decision. Certain medications can pass through the placenta. If a woman decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could 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. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. With two massive data sets researchers were able to examine more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers did find that first-trimester exposure to ADHD medicines was associated with an increased risk of specific heart defects, such as ventriculo-septal defect (VSD).
The researchers of the study didn't find any association between early use of medication and congenital anomalies like facial deformities or club feet. The results are in line with previous studies that showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to pregnancy. The risk was higher in the latter half of pregnancy, when many women decide to stop taking their medication.
Women who used ADHD medications in the first trimester of their pregnancies were also more likely to undergo a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance during birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who did not have any other medical conditions that could be a contributing factor to these findings.
The researchers hope that their research will help inform the clinical decisions of doctors who treat pregnant women. They recommend that, while discussing the risks and benefits is crucial however, the decision to stop or keep medication should be based on the woman's needs and the severity of her ADHD symptoms.
The authors warn that, even though stopping the medication is a possibility to think about, it isn't advised due to the high prevalence of depression and mental health issues among women who are pregnant or who have recently given birth. Research has also shown 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 challenge becoming a mother. Women who suffer from ADHD can face severe challenges when they must manage their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk at a low level. However, the rate of exposure to medications by the infant can differ based on the dosage, frequency it is administered, and the time of day the medication is administered. In addition, various medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not completely understood.
Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the lack of research. This is a difficult choice for the patient, who must balance the benefits of continuing her medication with the potential dangers to the foetus. As long as more information is available, GPs may ask pregnant patients if they have a history of ADHD or if they plan to take medication in the perinatal period.
Numerous studies have demonstrated that women can continue taking their ADHD medication safely during pregnancy and breast-feeding. In the end, more and more patients are choosing to do so, and in consultation with their physician, they have found that the benefits of continuing their current medication far outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and underlying disorder. They should also be educated about treatment options and strengthen strategies for coping. This should be a multidisciplinary effort together with obstetricians, GPs and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, monitoring of indicators of deterioration, and, if necessary modifications to the medication regimen.