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ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. There aren't enough data regarding how exposure over time may affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues 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 pregnant and taking ADHD medications need to balance the benefits of using them against the risks to the foetus. Doctors don't have the necessary data to provide clear recommendations but they can provide information regarding the risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have an increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large sample-based case control study to examine the prevalence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to minimize any bias.
However, the study was not without its flaws. In particular, they were not able to differentiate the effects of the medication from those of the underlying disorder. That limitation makes it difficult to know whether the small differences observed in the groups that were exposed result from medication use or the confounding effect of comorbidities. The researchers did not study the long-term effects for the offspring.
The study did find that infants whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or had stopped their medications before or during pregnancy. This increase was due to 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 chance of having an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both mother and child of continuing treatment for the woman's condition. Physicians should speak with their patients about this issue and try to help them improve coping skills which could reduce the effects of her disorder on her daily life and relationships.
Interactions with Medication
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or stop treatment during pregnancy is a question that more and more doctors have to face. These decisions are frequently made without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge and experience, as well as the experiences of other doctors and the research on the subject.
The issue of possible risks to infants is difficult to determine. The research on this subject is based on observation rather than controlled studies, and the results are in conflict. Most studies focus on live-births, which could underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both data on live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies have a neutral or slightly negative effect. In the end, a careful risk/benefit assessment is required in every case.
For many women with ADHD who suffer from ADHD, the decision to stop medication can be difficult, if not impossible. In fact, 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 Best Medicine For Adhd And Social Anxiety those suffering from the disorder. The loss of medication can also impact the ability to safely drive and perform work-related tasks, which are vital aspects of everyday life for those with ADHD.
She suggests that women who are not sure whether to take the medication or stop due to pregnancy, educate their family members, colleagues, and acquaintances about the condition, its impact on daily functioning and the benefits of keeping the current treatment. It can also help the woman feel supported in her struggle with her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug could be passed on to her baby.
Risk of Birth Defects
As the use and use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does adhd medication work the concern about the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two huge data sets to examine more than 4.3 million pregnancy and determine if the use of stimulant medications increased birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The researchers of the study could not find any association between the use of early medications and congenital anomalies like facial deformities, or club feet. The findings are in line with previous studies that have shown an increase, but not significant, in the risk of cardiac malformations in women who started taking ADHD medications prior to the birth of their child. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication.
Women who were taking 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 researchers of the study were not able to eliminate selection bias by limiting the study to women who didn't have other medical issues that could have contributed to the findings.
Researchers hope that their study will inform physicians when they see pregnant women. They suggest that although a discussion of the benefits and risks is important, the decision to stop or continue treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also caution that, while stopping adhd medication weekends adults the medication is an alternative, it is not an option that is recommended due to the high prevalence of depression and other mental health issues in women who are pregnant or who are recently post-partum. Furthermore, research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them after the birth of their baby.
Nursing
It can be a stressful experience becoming a mother. Women with ADHD who have to manage their symptoms while attending doctor appointments and getting ready for the arrival of their child and getting used to new routines at home can experience severe challenges. Many women decide 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 a low level. The amount of exposure to medications can vary depending upon the dosage and frequency of administration as well as the time of the day. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn isn't completely understood.
Due to the absence of research, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. It's a difficult choice for the woman who must weigh the advantages of taking her medication as well as the potential risks to the embryo. In the meantime, until more information is available, GPs may inquire about pregnant patients if they have any background of ADHD or if they intend to take medication in the perinatal period.
Numerous studies have proven that women can continue to take their ADHD medication safely while breastfeeding and during pregnancy. In response, an increasing number of patients are opting to continue their medication. They have concluded through consultation with their physicians that the benefits of retaining their current medication far outweigh any potential risks.
Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder Learn about the available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary approach including obstetricians, GPs, and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if needed adjustments to the medication regime.