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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect a foetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental conditions like hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the advantages of using them against the risks to the fetus. Physicians don't have the data to provide clear recommendations but they can provide information about risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers used a large population-based study of case control to compare the incidence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate case classification and to minimize the possibility of bias.

The study of the researchers had some limitations. In particular, they were unable to distinguish the effects of the medication from the disorder that is underlying. This makes it difficult for researchers to determine whether the small differences observed between the groups that were exposed to the use of medication or if they were affected by co-morbidities. In addition the researchers did not study long-term offspring outcomes.

The study revealed that infants whose mothers took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy or stopped taking their medication 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 influenced by the stimulant medications were used during pregnancy.

Women who used stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean birth or having a child with an low Apgar score (less than 7). These increases appeared to be independent of the type 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 greater benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies for improving their coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

Many doctors are faced with the decision of whether to keep treatment or stop as more women are diagnosed with ADHD. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other doctors, and the research on the subject.

In particular, the issue of potential risks for the baby can be a challenge. The research on this issue is based on observation rather than controlled studies and a lot of the results are in conflict. Most studies restrict their analysis to live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.

The conclusion: While some studies have shown an association between adhd medication pregnancy medications and the risk of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slightly negative impact. Therefore, a careful risk/benefit analysis is required in every situation.

For women suffering from adhd medication uk buy online, the decision to stop medication is difficult, if not impossible. In fact, in an article published in the 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. A loss of medication may affect the ability to safely drive and to perform work-related tasks which are vital aspects of daily life for people with ADHD.

She suggests that women who aren't sure whether to take the medication or discontinue it due to pregnancy, educate their family members, coworkers and friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment. Educating them can also help the woman feel supported when she is struggling with her decision. It is important to note that certain medications can pass through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be transferred to the child.

Birth Defects and Risk of

As the use and misuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Using two massive data sets researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, like ventriculo-septal defects (VSD).

The authors of the study didn't discover any connection between the use of early medications and other congenital anomalies like facial deformities or club feet. The findings are in line with previous studies showing the presence of a small, but significant increase in the risk of cardiac malformations among women who started taking ADHD medications prior to the time of the time of pregnancy. The risk was higher in the latter half 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 birth and had a baby that required help breathing at birth. The researchers of the study were not able to eliminate selection bias because they restricted the study to women with no other medical conditions that could have contributed to the findings.

Researchers hope that their study will inform physicians when they see pregnant women. They recommend that, while a discussion of the risks and benefits is crucial however, the decision to stop or keep treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, while stopping the medication is a possibility to consider, it is not advised due to the high prevalence of depression and other mental problems in women who are expecting or who have recently given birth. Further, research shows that women who stop taking their medications will have a difficult adjustment to life without them once the baby is born.

Nursing

It can be a stressful experience to become a mom. Women with ADHD who must work through their symptoms while attending doctor appointments as well as getting ready for the arrival of their child and getting used to new routines at home may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.

The risk to nursing infant is low because the majority of stimulant medication is absorbed through breast milk at low levels. However, the amount of medication exposure to the newborn may differ based on dosage, frequency it is taken and the time of the day the medication is administered. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn isn't fully comprehended.

Because of the lack of evidence, some doctors might be tempted to stop taking stimulant medications during the course of pregnancy. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the potential risks to the foetus. Until more information becomes available, doctors may inquire about pregnant patients if they have any history of ADHD or if they plan to take medication in the perinatal period.

A growing number of studies have shown that most common adhd medications women can safely continue to take their ADHD medication during pregnancy and breastfeeding. In the end, an increasing number of patients choose to do so and, in consultation with their doctor they have found that the benefits of maintaining their current medication outweigh any potential risks.

Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help women with adhd medication how does it work be aware of their symptoms and underlying disorder Learn about the available treatment options and strengthen existing coping strategies. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.