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ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these drugs can affect the fetus.

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, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.

Risk/Benefit Analysis

Pregnant women who use ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians don't have the data to give clear advice however they can provide information about risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers used a vast population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to ensure that the classification was accurate and to eliminate any bias.

The research conducted by the researchers was not without limitations. The researchers were not able to, in the first place, to separate the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the small associations observed among the exposed groups were due to the use of medication or if they were confounded by co-morbidities. The researchers also did not study long-term outcomes for the offspring.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system-related disorders and the increased risk for admission did not appear to be influenced by which stimulant medications were used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases didn't appear to be influenced by the kind of medication used during pregnancy.

The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits to both the mother and child from continued treatment for the woman's disorder. Physicians should speak with their patients about this issue and try to help them develop coping skills that may reduce the effects of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and treated with medication, the dilemma of whether to continue or end treatment during pregnancy is a question that more and more physicians face. These decisions are usually made without clear and reliable evidence. Instead, doctors have to consider their own expertise in conjunction with the experiences of other doctors and the research on the topic.

Particularly, the subject of possible risks to the baby can be tricky. Many studies on this issue are based on observational evidence rather than controlled research and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing data on live and deceased births.

The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the risk 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 each case it is imperative to conduct a thorough evaluation of the benefits and risks is required.

It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of isolation. Furthermore, a loss of medication can interfere with the ability to perform jobs and drive safely, which are important aspects of a normal life for many people suffering from adhd medication pregnancy.

She recommends women who are unsure about whether or not to stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily functioning, and the benefits of keeping the current treatment regimen. It can also help a woman feel confident about her decision. It is important to remember that some medications used for adhd can be absorbed through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug could be transferred to the child.

Risk of Birth Defects

As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases as does the concern about the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. With two massive data sets, researchers were able to look at more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.

The researchers 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 results are in line with previous studies which showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women stopped taking their medication.

Women who took ADHD medication in the first trimester of their pregnancy were also more likely to have caesarean section, low Apgar score after delivery and a baby that required breathing assistance at birth. The researchers of the study were not able to eliminate bias due to selection because they limited their study to women who did not have any other medical conditions that could have contributed to the findings.

Researchers hope their research will provide doctors with information when they meet pregnant women. The researchers suggest that, while discussing benefits and risks are crucial, the decision about whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and her requirements.

The authors also warn that, while stopping the medication for adhd and depression is an option, it isn't a recommended practice because of the high incidence of depression and other mental health problems for women who are expecting or post-partum. Research has also shown that women who stop taking their medication will have a tough time adjusting to a life without them once the baby is born.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, preparing for the arrival of a baby and getting used to new routines at home can experience severe challenges. Many women choose to continue taking their ADHD medication during pregnancy.

The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk in low amounts. However, the frequency of exposure to medication by the infant can differ based on dosage, frequency it is administered and at what time the medication is administered. In addition, various medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The impact of these medications on a newborn's health is not fully known.

Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the possible risks to the foetus. In the meantime, until more information is available, GPs 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 increasing number of studies have revealed that most women can safely continue their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are choosing to do so. They have concluded after consulting with their doctor that the benefits of keeping their current medication far outweigh any potential risks.

Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non medication treatment for adhd-pharmacological management strategies. Psychoeducation should also be offered to help women with ADHD recognize their symptoms and underlying disorder and learn about treatment options and reinforce existing strategies for coping. This should include a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration and, if needed modifications to the medication regime.