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 breastfeeding. There aren't enough data on how long-term exposure may affect a foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological disorders like impaired vision or hearing seizures, febrile seizures, or IQ impairment. adhd medication online acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to consider the benefits of taking it against the possible dangers for the fetus. The doctors don't have the information to make unambiguous recommendations, but can provide information on risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during 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 evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during early pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was accurate and to reduce any bias.
The research conducted by the researchers had some limitations. Researchers were unable in the beginning, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the groups that were exposed to the use of medications or if they were confounded by co-morbidities. Additionally the researchers did not look at the long-term effects of offspring on their parents.
The study did show 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 who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean birth or having a child with an low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication taken during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both the mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies to improve coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. These decisions are often made without clear and reliable evidence. Instead, doctors must weigh their own knowledge, the experience of other doctors and the research on the subject.
In particular, the issue of possible risks to the baby can be tricky. The research on this subject is based on observation rather than controlled studies, and the results are in conflict. Most studies limit their analysis to live-births, which could underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study discussed in the journal club addresses these issues by analyzing information on deceased and live births.
Conclusion Some studies have revealed an association between ADHD medications and certain birth defects, other studies have not established a link. The majority of studies show that there is a neutral, or somewhat negative, effect. In each case it is imperative to conduct a thorough analysis of the potential risks and benefits is required.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. 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 cause depression and feelings of being isolated. A loss of medication may affect the ability to drive safely and to perform work-related tasks which are vital aspects of normal life for those with ADHD.
She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers and acquaintances about the condition, its effects on daily functioning, and the benefits of keeping the current treatment. It can also help a woman feel supported in her decision. Some medications can pass through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug could be transferred to the baby.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about the effects that the drugs could have on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two huge data sets to examine more than 4.3 million pregnancies and determine if the use of stimulant medications increased birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with a slightly higher rate of certain heart defects such as ventriculoseptal defect (VSD).
The authors of the study found no link between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in line with previous studies which showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of the time of pregnancy. The risk grew during the latter part of pregnancy, as many women begin to discontinue their ADHD medications.
Women who took ADHD medication in the first trimester were more likely need a caesarean and also have a low Apgar after delivery and have a baby who needed help breathing after birth. adhd treatment without medication of the study were unable to eliminate bias due to selection because they limited the study to women without other medical conditions that could have contributed to the findings.
Researchers hope that their study will help doctors when they encounter pregnant women. The researchers recommend that, while discussing the risks and benefits are crucial, the decision regarding whether or not to stop medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also advise that even though stopping the medication is an alternative, it is not an option to consider due to the high incidence of depression and other mental health issues for women who are expecting or postpartum. Additionally, research suggests that women who stop taking their medications will have a difficult adjustment to life without them once the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women suffering from ADHD can face severe challenges when they have to manage their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The risk to nursing infant is low because the majority of stimulant medications passes through breast milk in low amounts. However, the amount of medication exposure to the newborn can vary depending on dosage, how often it is administered and at what time it is administered. Additionally, best adhd medication enter the body of the baby differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn isn't yet fully understood.
Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman, who must weigh the advantages of continuing her medication against the risk to the foetus. Until more information becomes available, doctors can ask pregnant patients if they have an background of ADHD or if they plan to take medication in the perinatal phase.
Numerous studies have proven that women can continue taking their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, an increasing number of patients are choosing to do so. They have discovered after consulting with their physicians, that the benefits of retaining their current medication outweigh potential risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the root cause Learn about the available treatment options and strengthen existing strategies for managing. This should involve a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration and, if necessary modifications to the medication regimen.