ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. There aren't many studies regarding how exposure over time may affect the pregnant fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the advantages of taking them against potential risks to the foetus. Physicians don't have the data to make unambiguous recommendations however they can provide information about risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast, population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure correct case classification and to limit the chance of bias.
However, the researchers' study had its limitations. Most important, they were unable to separate the effects of the medication from those of the underlying disorder. This limitation makes it difficult to determine whether the small associations observed in the groups that were exposed are due to medication use or confounding by comorbidities. In addition, the researchers did not look at long-term offspring outcomes.
The study did find that babies whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders, and the increased risk for admission was not found to be affected by the type of stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having a caesarean section or one whose baby scored low on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the minor risks associated with the use ADHD medications in early pregnancies could be offset by the greater benefits for mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, where possible, help them develop strategies to improve coping skills that may minimize the effects of her disorder on her daily functioning and relationships.
Interactions with Medication
Many doctors are faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are usually made 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 possible risks for infants can be difficult to determine. The research on this subject is based on observations instead of controlled studies and the results are conflicting. The majority of studies restrict their analysis to live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these issues by analyzing the data from deceased and live births.
Conclusion: While some studies have shown an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show a neutral, or even slightly negative, effect. Therefore, a careful risk/benefit assessment must be conducted in every situation.
For many women with ADHD, the decision to stop taking medication can be difficult, if not impossible. In fact, in a recent article in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for those suffering from the disorder. The loss of medication can affect the ability to safely drive and perform work-related tasks, which are crucial aspects of everyday life for those with ADHD.
She suggests that women who are unsure whether to continue taking medication or stop due to pregnancy should educate family members, colleagues, and their friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment regimen. It can also aid in ensuring that the woman feels supported in her struggle with her decision. It is also worth noting that some medications are able to pass through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the medication could be transferred to the child.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these drugs might have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study could not discover any connection between early medication usage and congenital anomalies like facial deformities, or club feet. The findings are in line with previous studies revealing a small but significant increase in the risk of developing cardiac malformations among women who started taking ADHD medications prior to the time of the birth of their child. This risk increased during the latter stages of pregnancy, when a lot of women began to stop taking their medication.
adhd medication uk buy online who took ADHD medication in the first trimester were more likely require a caesarean birth or have an insufficient Apgar after delivery, and had a baby that required help breathing after birth. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope that their research will provide doctors with information when they encounter pregnant women. The researchers recommend that, while discussing risks and benefits are crucial, the decision on whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors caution that, while stopping the medication is a possibility to think about, it isn't recommended because of the high incidence of depression and other mental problems among women who are pregnant or recently gave birth. Further, adhd depression medication shows that women who stop taking their medications will have a tough adjustment to life without them after the baby is born.
Nursing
It can be overwhelming to become a mom. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to new routines. 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 medications is absorbed through breast milk at low levels. However, the rate of exposure to medications by the infant can differ based on the dosage, frequency it is taken and the time of day the medication is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't fully understood.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must weigh the benefits of keeping her medication against the potential risks to the fetus. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal period.
A growing number of studies have shown that the majority of women are able to safely continue their ADHD medication during pregnancy and while breastfeeding. This has led to many patients choose to do so, and in consultation with their physician, they have discovered that the benefits of maintaining their current medication far outweigh any risks.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help women with ADHD understand their symptoms and underlying disorder Learn about the available treatment options and strengthen existing strategies for managing. This should be an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regime.