ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies on how long-term exposure may affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders such as impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Physicians don't have the data to provide clear recommendations, but can provide information about risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a greater risk of fetal malformations or structural birth defects. Researchers conducted a massive 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 accurate case classification and to minimize the possibility of bias.
However, the researchers' study had its limitations. The researchers were unable, in the first place to distinguish the effects caused by the medication from the disorder. This makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medications or affected by comorbidities. Researchers also did not study long-term outcomes for the offspring.
The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or taken off their medication prior to 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 medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases did not seem to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies may be offset by the greater benefits to both mother and baby from continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, help them develop strategies to improve coping skills which can reduce the negative impact of her condition on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to keep or discontinue treatment during pregnancy is one that more and more physicians face. These decisions are frequently taken without clear and authoritative evidence. Instead, physicians must take into account their own experience, the experience of other doctors and the research that has been conducted on the subject.
The issue of risk for infants can be difficult to determine. The research on this issue is based on observations instead of controlled studies and a lot of the results are conflicting. Most studies restrict their analysis to live-births, which could underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing both information on deceased and live births.
The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link, and most studies show a neutral or even slight negative effect. In every case an in-depth evaluation of the risks and benefits should be conducted.
For women suffering from ADHD who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for those suffering from the disorder. Additionally, the loss of medication may affect the ability to do work-related tasks and safely drive, which are important aspects of daily life for a lot of people with ADHD.
She recommends women who are uncertain about whether to continue or stop medication in light of their pregnancy should consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and the advantages of continuing the current treatment regimen. It can also help women feel supported in her decision. It is also worth noting that certain medications can pass through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the medication could be passed on to the baby.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the drugs could have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Using two massive data sets researchers were able examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. While click the next web page remains low, the scientists discovered that the first-trimester exposure to ADHD medicines was associated with a slightly higher rate of certain heart defects, such as ventriculo-septal defect (VSD).
The researchers of the study did not discover any link between early use of medication and other congenital anomalies, like facial deformities or club feet. The results are in line with previous studies showing an increase, but not significant, in the risk of cardiac malformations in women who started taking ADHD medications before the birth of their child. The risk grew during the latter part of pregnancy, as many women decide to stop taking their ADHD medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean birth, have a low Apgar after delivery and have a baby that needed breathing assistance after birth. The researchers of the study could not eliminate bias due to selection because they limited the study to women with no other medical conditions that could have contributed to the findings.
Researchers hope that their study will help doctors when they encounter pregnant women. They advise that while a discussion of risks and benefits is important, the decision to stop or keep treatment should be based on the woman's needs and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is an option to look into, it is not recommended due to the high rate depression and mental health issues in women who are expecting or recently gave birth. Furthermore, research suggests that women who decide to stop their medications are more likely to experience difficulties getting used to life without them after the baby's arrival.
Nursing
It can be overwhelming becoming a mother. Women with ADHD who must work through their symptoms while attending doctor appointments as well as making preparations for the arrival of a baby and adapting to new routines in the home are often faced with a number of difficulties. Therefore, many women choose to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines pass through breast milk in very small amounts, therefore the risk to the breastfeeding infant is minimal. However, the frequency of exposure to medication by the newborn can vary depending on dosage, how often it is administered, and the time of day the medication 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 infant is not yet fully known.
Due to the absence of evidence, some doctors may recommend stopping stimulant medication during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the risks to the foetus. As long as more information is available, GPs can ask pregnant patients whether they have an background of ADHD or if they plan to take medication during the perinatal stage.
Numerous studies have demonstrated that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to continue their medication. They have found through consultation with their doctors, that the benefits of retaining their current medication outweigh potential risks.
Women with ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and strengthen strategies for coping. This should be a multidisciplinary process including obstetricians, GPs and psychiatrists. Pregnancy counselling should include discussion of a management plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.