ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how exposure to ADHD for a long time could affect a fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological conditions like impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to weigh the benefits of taking it against the possible dangers for the foetus. The doctors don't have the information to give clear advice however they can provide information on the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a massive sample-based case control study to compare the incidence of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was correct and to minimize any bias.
However, the study was not without its flaws. Researchers were unable to, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the small associations observed among the groups exposed were due to medication use or confounded by comorbidities. In addition the study did not examine the long-term effects of offspring on their parents.
The study did reveal that infants whose mothers took ADHD medications during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had cut back on their medications prior to or during pregnancy. The reason for this was central nervous system-related disorders and the higher risk of admission did not appear to be influenced by which stimulant medications were used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a baby with a low Apgar score (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both mother and child of continued treatment for the woman's disorder. Physicians should discuss this with their patients and, when they are able, assist them in developing strategies to improve their coping abilities that can lessen the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. Often, these decisions are made in the absence of clear and authoritative evidence regardless, so doctors must weigh their knowledge from their own experiences, those of other doctors, and what the research says on the topic, along with their own best judgment for each patient.
Particularly, the issue of potential risks for the baby can be a challenge. A lot of studies on this subject are based on observational data rather than controlled research, and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these issues by analyzing data on live and deceased births.
The conclusion is that while certain studies have demonstrated an association between adhd medication weight Loss uk medications and the possibility of certain birth defects, other studies have found no connection, and most studies have a neutral or slight negative effect. In each case it is imperative to conduct a thorough analysis of the benefits and risks is required.
For a lot of women with ADHD, 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 increase depression and feelings of isolation. The loss of medication can also impact the ability to safely drive and complete work-related tasks, which are essential aspects of everyday life for those with ADHD.
She recommends women who are unsure about whether to keep or stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily life, and the advantages of continuing the current treatment regimen. It can you get adhd medication without a diagnosis uk also help the woman feel supported in her struggle with her decision. Certain medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the medication could be transferred to the baby.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (starting adhd medication adults) increases as does the concern about the possible effects of the drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medicines was associated with a slightly higher rate of specific heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study found no link between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies revealing a small but significant increase in the risk of heart malformations among women who started taking ADHD medications before pregnancy. The risk increased in the latter stages of pregnancy, when a lot of women began to stop taking their medication.
Women who took adhd medication weight loss uk medication during the first trimester were more likely to require a caesarean delivery, have a low Apgar after delivery, and have a baby that needed breathing assistance when they were born. However the researchers of the study were not able to eliminate bias due to selection by limiting the study to women who did not have any other medical issues that could have contributed to the findings.
Researchers hope their research will inform physicians when they meet pregnant women. They suggest that although discussing the benefits and risks is important however, the decision to stop or maintain 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 an option to consider, it is not recommended due to the high prevalence of depression and other mental disorders among women who are pregnant or recently gave birth. Furthermore, research suggests that women who choose to stop taking their medication are more likely to experience difficulties getting used to life without them after the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments, making preparations for the arrival of their child and adapting to new routines in the home may face a lot of challenges. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk at a low level. The amount of exposure to medications can vary depending upon the dosage, frequency of administration and the time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn infant is not yet fully known.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication with the potential risks to the foetus. As long as there is no more information, doctors should inquire with all pregnant patients about their history of cheapest adhd medication and if they are planning or taking to take medication during the perinatal time.
A growing number of studies have proven that most common adhd medication uk women can safely continue their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are choosing to continue their medication. They have discovered after consulting with their physicians that the benefits of keeping their current medication outweigh any potential risks.
It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also required to help women with ADHD be aware of their symptoms and the underlying disorder, learn about available treatments and to reinforce existing strategies for managing. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.