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 many studies regarding how exposure over time may affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological conditions like impaired vision or hearing seizures, 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 consider the benefits of taking it against the possible risks to the fetus. The doctors don't have the information to provide clear recommendations, but can provide information on the risks and benefits to assist pregnant women to make informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers conducted a large, population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was correct and to eliminate any bias.
However, the study was not without its flaws. Researchers were unable in the beginning, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to establish whether the few associations observed between the groups that were exposed to the use of medication or if they were caused by co-morbidities. In addition, the researchers did not examine the long-term effects of offspring on their parents.
The study found that babies whose mothers had taken ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy, or had stopped taking their medication before 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 were taking stimulant non prescription adhd medication medication during pregnancy also had an elevated chance of having a caesarean delivery or having a child 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.
Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies can be offset by more beneficial outcomes for both mother and baby of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, assist them in developing strategies to improve coping skills that may minimize the negative impact of her condition on her daily life and relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests on the subject and their own best judgment for each patient.
Particularly, the issue of potential risks to the infant can be difficult. A lot of studies on this topic are based on observational evidence rather than controlled research, and their conclusions 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 the journal club addresses these limitations by analyzing the data from deceased and live births.
The conclusion is that while some studies have shown an association between ADHD medications and the risk of certain birth defects, others have found no such relationship, and most studies show a neutral or even slightly negative effect. In the end, a careful risk/benefit analysis must be done in each case.
For a lot of women with ADHD who suffer from ADHD, the decision to stop taking medication is difficult if not impossible. 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 lead to depression and feelings of being isolated. A loss of medication for odd And adhd may also impact the ability to drive safely and complete work-related tasks, which are crucial aspects of everyday life for people with ADHD.
She suggests that women who aren't sure whether to take the medication or stop due to pregnancy, educate their family members, coworkers, and their friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also help women feel confident about her decision. It is also worth noting that certain medications can be absorbed through the placenta so if the patient decides to discontinue her adhd depression medication medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the infant.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these drugs might have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Utilizing two huge data sets, researchers were able to look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects, like ventriculo-septal defects (VSD).
The researchers of the study found no connection between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are in line with previous studies revealing a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. This risk increased during the latter stages of pregnancy when a large number of women stopped taking their medication.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean delivery or have an insufficient Apgar after delivery, and have a baby that needed breathing assistance after birth. The authors of the study were not able to eliminate selection bias because they limited the study to women with no other medical conditions that might have contributed to the findings.
The researchers hope their research will help inform the clinical decisions of doctors who treat pregnant women. They advise that while a discussion of risks and benefits is important however, the decision to stop or maintain medication should be based on each woman's needs and the severity of her uk adhd medication symptoms.
The authors caution that, although stopping the medication is a possibility to consider, it is not recommended because of the high incidence of depression and other mental disorders among women who are pregnant or who have recently given birth. Additionally, the research suggests that women who choose to stop their medications are more likely to have difficulties adjusting to life without them following the birth of their baby.
Nursing
It can be a challenge becoming a mother. Women with ADHD can face severe challenges when they must deal with their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed by breast milk in low amounts, therefore the risk to the nursing infant is very low. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency 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 is not yet fully understood.
Because of the lack of research, some doctors may recommend stopping stimulant drugs during the pregnancy of a woman. This is a complicated decision for the patient, who must weigh the benefits of keeping her medication against the potential dangers to the fetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they plan or are taking to take medication during the perinatal time.
A growing number of studies have proven that women can continue taking their ADHD medication during pregnancy and while breastfeeding. In the end, more and more patients choose to do so and in consultation with their doctor they have discovered that the benefits of maintaining their current medication outweigh any risks.
Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons of continuing treatment. This includes non prescription adhd medication uk-pharmacological methods. Psychoeducation is also required to help women with ADHD understand their symptoms and the underlying disorder Learn about the available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, as well as monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.