ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies regarding how exposure over time may affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to weigh the benefits of taking it versus the dangers for the baby. Physicians don't have the data needed to give clear guidelines, but they can provide information regarding the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy did not have a higher risk of fetal malformations or structural birth defects. The researchers used a large, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to limit the chance of bias.
The study of the researchers was not without its limitations. Researchers were unable to, in the first place to distinguish the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the few associations observed between the exposed groups were due to the use of medications or if they were caused by the presence of comorbidities. Additionally, click through the next website page did not study long-term offspring outcomes.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had cut back on their medications prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean section or having a baby born with a low Apgar score (less than 7). These increases appear to be independent of the type of medication taken 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 higher benefit to both mother and child from continued treatment for the woman's disorder. Doctors should discuss with their patients about this issue and as much as possible, assist them improve coping skills which could reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to keep or stop treatment during pregnancy is one that more and more doctors face. The majority of these decisions are made without clear and authoritative evidence in either case, which means that doctors have to weigh their experience from their own experiences, those of other doctors, and what research suggests about the subject and their best judgment for each individual patient.
The issue of potential risks to infants is difficult to determine. Many of the studies on this issue are based on observational evidence rather than controlled research, and their conclusions are often contradictory. The majority of studies focus on live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both data on live and deceased births.
The conclusion The conclusion: While some studies have found an association between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slightly negative impact. In each case it is imperative to conduct a thorough analysis of the benefits and risks must be performed.
For many women with ADHD who suffer from ADHD, the decision to stop taking medication can be 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 increase depression, feelings of isolation and family conflict for patients with ADHD. The loss of medication can affect the ability to safely drive and perform work-related tasks, which are essential aspects of daily life for people with ADHD.
She recommends women who are uncertain about whether to keep 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 staying on the current treatment plan. In addition, educating them can help the woman feel supported in her struggle with her decision. Certain medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the medication could be passed on to her baby.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the possible effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two massive data sets to examine over 4.3 million pregnant women and determine if the use of stimulant medications increased birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defect.
The researchers of the study could not discover any link between the use of early medications and congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies that showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication before 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 took ADHD medication in the first trimester were more likely require a caesarean birth or have a low Apgar after delivery, and have a baby that needed help breathing when they were born. The authors of the study were not able to eliminate selection bias because they limited their study to women with no other medical conditions that could have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of physicians who treat pregnant women. They suggest that although the discussion of the risks and benefits is crucial, the decision to stop or maintain medication should be based on the woman's needs and the severity of her ADHD symptoms.
The authors also caution that while discontinuing the medications is an option, it is not an option to consider due to the high rate of depression and other mental health issues in women who are pregnant or post-partum. Further, the research suggests that women who decide to stop taking their medication are more likely to have difficulties adjusting to life without them after the baby's arrival.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments, making preparations for the arrival of a baby and getting used to new routines at home are often faced with a number of difficulties. Therefore, many women decide to continue taking their ADHD medication throughout the pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk in low amounts. However, the amount of medication exposure to the newborn can vary depending on dosage, frequency it is administered and the time of the day it is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't fully understood.
Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman who must weigh the advantages of her medication against the risks to the fetus. Until more information becomes available, GPs may ask pregnant patients whether they have an history of ADHD or if they plan to take medication in the perinatal phase.
Numerous studies have demonstrated that women can continue to take their ADHD medication without risk while breastfeeding and during pregnancy. In response, a growing number of patients are opting to do this. They have discovered, in consultation with their physicians that the benefits of continuing their current medication far outweigh any risk.
It is crucial for women suffering from ADHD who are considering breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and the root cause Learn about the available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. 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.