ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There isn’t much information on how long-term exposure to these drugs may affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality research is needed.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the advantages of taking them against the potential risks to the foetus. Doctors don’t have the necessary data to make unequivocal recommendations, but they can provide information regarding the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers used a large sample-based case control study to compare the incidence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was accurate and to eliminate any bias.
The study conducted by the researchers was not without limitations. The most important issue was that they were not able to differentiate the effects of the medication from the disorder at hand. This makes it difficult for researchers to determine whether the small associations observed among the groups exposed were due to the use of medication, or if they were caused by co-morbidities. In addition the study did not examine the long-term outcomes of offspring.
The study did find that infants whose mothers took ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases didn’t appear to be influenced by the kind of medication used during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefit for both mother and child of continued treatment for the woman’s disorder. Physicians should talk to their patients about this issue and, if possible, help them improve coping skills which can lessen the impact of her disorder in her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to continue or discontinue treatment during pregnancy is one that doctors are having to have to face. The majority of these decisions are made without solid and reliable evidence either way, so physicians must weigh what they know about their experiences, the experiences of other doctors, and what the research suggests about the subject and their best adhd medication uk judgment for each patient.
Particularly, the subject of potential risks to the baby can be a challenge. Many studies on this subject are based on observational data rather than controlled research, and their findings are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the teratogenic impact that can lead to abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these issues by examining data on both live and deceased births.
Conclusion Some studies have found a positive correlation between ADHD medications and certain birth defects However, other studies haven’t shown such a relationship. Most studies have shown a neutral, or even slight negative impact. In all cases, a careful study of the potential risks and benefits is required.
For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In fact, in a recent article in Archives of Women’s Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for these patients. Additionally, the loss of medication may affect the ability to do job-related tasks and drive safely, which are important aspects of a normal life for many people with ADHD.
She recommends women who are uncertain about whether to keep or stop medication in light of their pregnancy should consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily functioning, and the benefits of keeping 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 a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the child.
Risk of Birth Defects
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (adhd medication guide) increases there are concerns over the impact that these drugs could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study found no link between early use of medication and other congenital anomalies, like facial clefting, or club foot. The results are in the same vein as previous studies that have shown an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the time of pregnancy. The risk was higher during the latter part of pregnancy, when a lot of women begin to discontinue their ADHD medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean delivery and also have an insufficient Apgar after delivery and had a baby that required breathing assistance after birth. The researchers of the study were unable to eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings.
Researchers hope that their study will provide doctors with information when they meet pregnant women. They advise that while a discussion of risks and benefits is important however, the decision to stop or continue medication should be based on each woman’s needs and the severity of her ADHD symptoms.
The authors caution that, while stopping the medication is an option to think about, it isn’t recommended because of the high incidence of depression and mental health issues for women who are pregnant or recently gave birth. Research has also shown that women who stop taking their medication will have a harder time adjusting to a life without them after 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, attend doctor appointments, prepare for the birth of their child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to a breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk in low amounts. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and the time of day. In addition, different medications are introduced into the baby’s system through the gastrointestinal tract or breast milk. The effect on the health of a newborn isn’t completely comprehended.
Some doctors may stop taking stimulant medications during a woman’s pregnancy due to the absence of research. This is a difficult choice for the patient, who can prescribe adhd medication for adults must weigh the benefits of keeping her medication against the potential dangers to the foetus. Until more information becomes available, doctors can ask pregnant patients whether they have any history of ADHD or if they intend to take medication during the perinatal period.
Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and while breast-feeding. In the end, an increasing number of patients choose to do so and, after consulting with their doctor, they have discovered that the benefits of keeping their current medication outweigh any risks.
Women with ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD be aware of their symptoms and the underlying disorder Learn about the available treatments and to reinforce existing strategies for coping. This should be a multidisciplinary approach including obstetricians, GPs, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, as well as monitoring for indicators of deterioration, and, if needed adjustments to the medication Given for Adhd regimen.