ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and nursing is challenging for women with the condition. There isn't much information on how to get adhd medication without diagnosis long-term exposure to these drugs could affect the foetus.
A recent study 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 that further high-quality studies are needed.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the benefits of using them against the risks to the fetus. Physicians don't have the data needed to give clear guidelines however they can provide information on benefits and risks that can help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large sample-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate case classification and to minimize the chance of bias.
The research conducted by the researchers was not without limitations. The researchers were unable, in the first place to distinguish the effects of the medication from the disorder. This makes it difficult to determine whether the small differences observed in the exposed groups are due to medication use or confounding by comorbidities. The researchers also did not study the long-term effects for the offspring.
The study found that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) as compared to those whose mothers didn't take any medication during pregnancy or stopped taking their medication before or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk for admission was not found to be affected by the type of stimulant medication was used during pregnancy.
Women who were taking stimulant generic adhd medications medications during pregnancy also had a higher likelihood of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases did appear to be independent of the type of medication taken 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 baby and mother of continued treatment for the woman's disorder. Physicians should speak with their patients about this and as much as possible, assist them develop coping skills that could reduce the effects of her disorder on her daily functioning and her relationships.
Interactions with Medication
More and more doctors are faced with the decision of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to consider their own expertise, the experience of other doctors and the research on the topic.
The issue of risk for infants can be extremely difficult. Many of the studies on this topic are based on observational evidence rather than controlled research, and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which may undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.
Conclusion A few studies have shown a positive correlation between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies have shown a neutral, or even slightly negative, effect. In each case an in-depth study of the potential risks and benefits must be performed.
For many women with ADHD, the decision to stop medication is difficult, if not impossible. In a recent article in the 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 these patients. A loss of medication may also affect the ability to safely drive and complete work-related tasks, which are essential aspects of everyday life for people with all adhd medications.
She suggests women who are uncertain about whether to keep or discontinue medication due to their pregnancy consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the benefits of keeping the current treatment regimen. It can also help women feel supported in her decision. Certain medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the medication could be transferred to the infant.
Birth Defects and Risk of
As the use and misuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Using two massive data sets, researchers were able to analyze more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects, such as ventriculo-septal defect (VSD).
The authors of the study found no association between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies showing an increase, but not significant, in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. The risk increased in the latter stages of pregnancy when many women decided to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean birth, have an insufficient Apgar after delivery, and have a baby that needed breathing assistance after birth. However, the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical issues that could have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of physicians who treat pregnant women. They recommend that, while the discussion of the risks and benefits is crucial however, the decision to stop or keep medication should be based on the woman's requirements and the severity of her ADHD symptoms.
The authors also advise that while discontinuing the medications is an alternative, it is not an option to consider due to the high rate of depression and other mental health issues in women who are pregnant or recently postpartum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have a difficult time adjusting to life without them after the birth of their baby.
Nursing
The responsibilities that come with being a new mom can i get adhd medication without a diagnosis be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments as well as preparing for the arrival of a baby and adapting to new routines in the home can experience severe challenges. Therefore, many women decide to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medications are absorbed by breast milk in low quantities, so the risk for breastfeeding infant is minimal. However, the rate of exposure to medication by the infant can differ based on dosage, how often it is administered, and at what time the medication is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not fully understood.
Some doctors may stop taking 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 keeping her medication against the possible risks to the foetus. Until more information becomes available, GPs may inquire about pregnant patients if they have a history of ADHD or if they plan to take medication during the perinatal stage.
A increasing number of studies have shown that the majority of women are able to safely continue taking their ADHD medication during pregnancy and breastfeeding. In the end, more and more patients choose to do so and after consulting with their doctor, they have discovered that the benefits of continuing their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder, learn about available treatment options and reinforce existing strategies for managing. This should include a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration and, if necessary modifications to the medication regime.