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ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There isn't much information on how long-term exposure to these medications could affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to evaluate the benefits of using it against the possible risks to the fetus. Physicians don't have the data needed to provide clear recommendations but they can provide information about benefits and risks that can help pregnant women make informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy did not have a greater risk of fetal malformations, or 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 were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was correct and to minimize any bias.
The study of the researchers was not without limitations. The most important issue was that they were not able to differentiate the effects of the medication from those of the disorder that is underlying. This limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. In addition, the researchers did not examine the long-term effects of offspring on their parents.
The study did show that babies whose mothers had taken ADHD medications during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had stopped their medications before or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a child with low Apgar score (less than 7). These increases didn't appear to be influenced by the kind of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit to both mother and child from continued treatment for the woman's condition. medications for adhd should talk to their patients about this issue and, if possible, help them develop coping strategies that could reduce the impact of her disorder in her daily functioning and her relationships.
medication for adult adhd and more doctors are faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made without solid and reliable evidence regardless, so doctors must weigh what they know, the experiences of other doctors, and what the research suggests on the subject as well as their best judgment for each individual patient.
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. Furthermore, most studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.
The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative impact. Therefore, a careful risk/benefit assessment is required in every situation.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published 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 those suffering from the disorder. A decrease in medication could also affect the ability to drive safely and perform work-related tasks, which are essential aspects of daily life for those suffering from ADHD.
She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy, educate their family members, colleagues, and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment plan. Educating them can also aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can be passed through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it is important to be aware that the drug could be transferred to the infant.
Birth Defects and Risk of
As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing as does the concern about the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Utilizing two huge data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.
The researchers of the study could not discover any connection between the use of early medications and congenital anomalies such as facial deformities or club feet. The results are in line with previous studies that have shown the presence of a small, but significant increase in the risk of heart malformations among women who started taking ADHD medications prior to the birth of their child. The risk was higher in the later part of pregnancy, when a lot of women decide to stop taking their ADHD medications.
Women who took ADHD medication during 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 at birth. The authors of the study were not able to eliminate bias due to selection because they restricted the study to women with no other medical conditions that could have contributed to the findings.
Researchers hope that their research will provide doctors with information when they meet pregnant women. They recommend that, while the discussion of the risks and benefits is crucial however, the decision to stop or continue treatment should be based on the woman's needs and the severity of her ADHD symptoms.
The authors also warn that, while stopping the medication is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health issues in women who are pregnant or recently postpartum. Research has also shown that women who stop taking their medication will have a tough time adjusting to a life without them after the baby is born.
Nursing
It can be a challenge to become a mom. Women with ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. Therefore, many women choose to continue taking their ADHD medication throughout the pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk at a low level. However, the frequency of medication exposure to the infant can differ based on dosage, frequency it is administered and the time of the day the medication is administered. In addition, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't completely comprehended.
Some physicians may discontinue stimulant medication 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 continuing her medication with the potential risks to the fetus. As long as more information is available, GPs can inquire about pregnant patients whether they have a history of ADHD or if they plan to take medication during the perinatal stage.
Many studies have shown that women can continue taking their ADHD medication without risk while breastfeeding and during pregnancy. In response, a rising number of patients are choosing to continue their medication. They have discovered through consultation with their doctor that the benefits of retaining their current medication outweigh possible risks.
Women with ADHD who are planning to nurse should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should involve a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration and, if needed modifications to the medication regime.