ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during pregnancy and nursing is a difficult decision for women suffering from the condition. There isn't much information on how long-term exposure to these drugs may affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological disorders such as hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against potential risks to the foetus. Physicians do not have the information needed to give clear guidelines however they can provide information about benefits and risks that can assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a large sample-based case control study to assess the frequency of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to make sure that the classification was accurate and to reduce any bias.
The research 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 limitation makes it difficult for researchers to determine if the small associations observed among the groups that were exposed to the use of medications or if they were confounded by the presence of comorbidities. Researchers also did not examine long-term outcomes for the offspring.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases appear to be independent of the type of medication used during pregnancy.
Researchers suggest that the minor risks associated with the use ADHD medications in early pregnancies may be offset by the more beneficial outcomes for both mother and baby from 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 which can reduce the impact of her disorder on 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 stop treatment during pregnancy is one that more and more doctors face. The majority of these decisions are made without solid and reliable evidence either way, so physicians have to weigh their experience from their own experiences, those of other doctors, and what the research says on the topic as well as their own judgments for each patient.
The issue of possible risks to the infant can be particularly tricky. The research on this subject is based on observation rather than controlled studies and a lot of the results are in conflict. Most studies focus on live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study presented in the journal club addresses these limitations, by examining both information on deceased and live births.
Conclusion Some studies have found an association between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies have shown a neutral, or even somewhat negative, impact. In all cases it is imperative to conduct a thorough evaluation of the potential risks and benefits is required.
It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In a recent article published in 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 isolation. Additionally, the loss of medication can affect the ability to complete jobs and drive safely which are essential aspects of daily life for a lot of people with ADHD.
She recommends women who are uncertain about whether or not to stop taking medication because of their pregnancy should consider informing family members, friends and colleagues on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. It can also help a woman feel more confident in her decision. It is also worth noting that certain medications can pass through the placenta, therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug can be transferred to the child.
Birth Defects Risk
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about what impact the medications could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two huge data sets to study over 4.3 million pregnant women and determine whether stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increase in the risk of specific heart defects, such as ventriculo-septal defect (VSD).
just click the following internet site behind the study found no connection between early use of medication and other congenital anomalies, such as facial clefting or club foot. The findings are in line with previous studies revealing an increase, but not significant, in the risk of heart malformations among women who started taking ADHD medications prior to the birth of their child. The risk increased in the latter stages of pregnancy when many women decided to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean delivery and also have a low Apgar after birth 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 restricted the study to women who did not have any other medical conditions that might have contributed to the findings.
The researchers hope that their research will help inform the clinical decisions of doctors who encounter pregnant women. The researchers recommend that, while discussing benefits and risks are important, the decision on whether to continue or stop taking medication should be based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors caution that, even though stopping the medication is an option to think about, it isn't advised due to the high rate depression and mental health issues for women who are pregnant or recently gave birth. Additionally, research suggests that women who stop taking their medication will have a tough adjustment to life without them once the baby is born.
Nursing
It can be overwhelming becoming a mother. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments, making preparations for the arrival of their child and getting used to new routines at home may face a lot of challenges. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to a breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk at low levels. However, the rate of exposure to medication by the newborn can vary depending on dosage, how often it is taken and the time of the day it is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn isn't yet fully known.
Because of the lack of research, some physicians might be tempted to stop taking stimulant drugs during the pregnancy of a woman. It's a difficult choice for the mother, who must weigh the benefits of taking her medication as well as the potential risks to the embryo. Until more information becomes available, GPs can inquire about pregnant patients whether they have a background of ADHD or if they intend to take medication during the perinatal stage.
A increasing number of studies have proven that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. In the end, an increasing number of patients are choosing to do so and, after consulting with their doctor, they have discovered that the benefits of continuing their current medication exceed any risk.
Women who suffer from ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and reinforce coping mechanisms. This should be a multidisciplinary process together with obstetricians, GPs and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regime.