ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications could affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the benefits of taking them against the potential risks to the fetus. Doctors don't have the necessary data to give clear guidelines, but they can provide information regarding risks and benefits that help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. The researchers used a large population-based study of case-control to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants in the early stages of pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias.
However, the study was not without its flaws. The researchers were unable in the beginning, to separate the effects caused by the medication from the disorder. This makes it difficult for researchers to determine if the few associations observed between the groups that were exposed to the use of medications or affected by comorbidities. Additionally the study did not look at the long-term outcomes of offspring.
The study did show that babies 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 were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system-related disorders and the increased risk for admission did not appear to be influenced by the stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases did appear to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medications during early pregnancies could be offset by the greater benefits to both mother and baby from continuing treatment for the woman's condition. Doctors should discuss with their patients about this issue and, if possible, help them develop coping skills that may reduce the impact of her disorder in her daily functioning and her relationships.
medication for adult add
As more women than ever are being diagnosed with ADHD and treated with medication, the dilemma of whether or not to stop treatment during pregnancy is one that more and more physicians face. Most of the time, these decisions are made without solid and reliable evidence in either case, which means that doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests about the subject as well as their own best judgment for each individual patient.
Particularly, the issue of potential risks to the baby can be tricky. Many of the studies on this issue are based on observations rather than controlled research, and their findings are often contradictory. The majority of studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study discussed in this journal club addresses these issues by analyzing data on live and deceased births.
Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies have shown a neutral, or even slight negative impact. In the end an accurate risk-benefit analysis must be done in each case.
It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In fact, in a recent article in the 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 patients with ADHD. A decrease in medication could affect the ability to drive safely and perform work-related tasks, which are vital aspects of normal life for people with ADHD.
She recommends women who are uncertain about whether or not to stop medication in light of their pregnancy should consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of staying on the current treatment regimen. In addition, educating them can make the woman feel more comfortable in her struggle with her decision. It is important to note that some medications can be absorbed through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the infant.
Birth Defects Risk
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two massive data sets to examine more than 4.3 million pregnancies and determine whether stimulant medications increased 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, such as ventriculoseptal defect.
The authors of the study could not find any association between early medication usage and congenital anomalies like facial deformities, or club feet. The results are consistent with previous studies that have shown a small but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of pregnancy. This risk increased during the latter part of pregnancy when many women began to stop taking their medication.
Women who used ADHD medications during the first trimester of their pregnancy were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby that required help breathing at birth. medication for adults with add of the study were unable to eliminate bias due to selection because they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of doctors who encounter pregnant women. They recommend that, while discussing risks and benefits is important however, the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is a possibility to consider, it is not advised due to the high prevalence of depression and mental health issues among women who are pregnant or have recently given birth. Further, research shows that women who stop taking their medications will have a difficult transitioning to life without them once the baby is born.
Nursing
The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments, getting ready for the arrival of a baby and getting used to new routines at home are often faced with a number of difficulties. Many women choose to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small amounts, therefore the risk to the breastfeeding infant is minimal. 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, different medications are introduced into the baby's system through the gastrointestinal tract, or through breast milk. The impact on the health of a newborn isn't completely comprehended.
Due to the absence of research, some doctors may recommend stopping stimulant medication during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risk to the foetus. In the meantime, until more information is available, GPs can ask pregnant patients whether they have a background of ADHD or if they intend to take medication in the perinatal phase.
A increasing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. In medication for adult add , a rising number of patients are opting to do so. They have found, in consultation with their doctors, that the benefits of continuing their current medication far outweigh any risk.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder Learn about the available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, and monitoring for indicators of deterioration, and, if necessary modifications to the medication regime.