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ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these medications may affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders such as hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to evaluate the benefits of using it against the potential risks for the fetus. Doctors don't have enough data to give clear advice, but can provide information on the risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during 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 assess the risk of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was accurate and to minimize any bias.
However, the researchers' study had its limitations. Most important, they were unable to distinguish the effects of the medication from the effects of the disorder at hand. That limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to medication use or confounding by comorbidities. The researchers also did not look at long-term outcomes for the offspring.
The study did find that infants whose mothers had taken ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or cut back on their medications prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or a baby that scored low 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 low risk associated 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 discuss the issue with their patients and, when possible, help them develop strategies for improving their coping skills that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to keep or discontinue treatment during pregnancy is one that more and more physicians face. Most of the time, these decisions are made without solid and reliable evidence either way, so physicians must weigh what they know about their experiences, the experiences of other doctors, and what research suggests on the subject, along with their own judgments for each patient.
The issue of risk for infants can be extremely difficult. The research on this subject is based on observation instead of controlled studies and a lot of the results are conflicting. In addition, most popular adhd medication (get redirected here) studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study presented in the journal club addresses these limitations by analyzing information on deceased and live births.
The conclusion The conclusion: While certain studies have demonstrated a positive association between ADHD medications and the risk of certain birth defects, others have found no such relationship, and most studies show a neutral or even slightly negative effect. In the end, a careful risk/benefit analysis is required in every situation.
It can be challenging, if not impossible, for women with ADHD to stop taking their medication. In fact, in an article published in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping adhd medication list medication during pregnancy can increase depression, feelings of loneliness and family conflict for these patients. Furthermore, a loss of medication can interfere with the ability to do job-related tasks and drive safely which are essential aspects of daily life for many people with ADHD.
She suggests women who are uncertain about whether or not to stop taking medication because of their pregnancy consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and on the advantages of staying on the current treatment regimen. It can also help a woman feel more confident in her decision. It is important to remember that some medications can be absorbed through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the medication could be passed on to the baby.
Risk of Birth Defects
As the use and misuse of adhd non stimulant medication uk medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers utilized two massive datasets to analyze more than 4.3 million pregnancy and determine if the use of stimulant medications increased birth defects. While the overall risk remains low, the scientists discovered that the first-trimester exposure to ADHD medications was associated with a slightly higher rate of certain heart defects like ventriculo-septal defects (VSD).
The researchers of the study found no association between early medication use and other congenital anomalies, such as facial clefting or club foot. The results are in line with previous studies that have shown the existence of a slight, 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 part of pregnancy, when a lot of women began to stop taking their medication.
Women who used ADHD medications in the first trimester of their pregnancy were also more likely to have caesarean section, low Apgar score after delivery and a baby who required breathing assistance during birth. The researchers of the study could not eliminate bias due to selection because they limited their study to women without other medical conditions that might have contributed to the findings.
Researchers hope that their study will inform physicians when they encounter pregnant women. They advise that while the discussion of risks and benefits 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 advise that even though stopping the medication is an option, it isn't an option that is recommended due to the high rate of depression and other mental health issues in women who are pregnant or recently post-partum. Further, the research suggests that women who choose to stop their medications are more likely to experience a difficult time getting used to life without them after the baby's arrival.
Nursing
The responsibilities of being a new mother can be overwhelming. Women who suffer from adhd medication list uk who have to manage their symptoms while attending doctor appointments as well as getting adhd medication uk ready for the arrival of a baby and adapting to new routines in the home can experience severe challenges. This is why 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 is absorbed through breast milk at low levels. However, the amount of exposure to medication by the newborn can vary depending on dosage, frequency it is administered, and the time of the day the medication is administered. In addition, different drugs enter the infant's system via the gastrointestinal tract or through breast milk. The effect on the health of a newborn is not completely comprehended.
Because of the lack of research, some doctors may recommend stopping adhd medication adults stimulant medication during the pregnancy of a woman. This is a complicated decision for the patient, who must weigh the benefits of keeping her medication with the potential risks to the foetus. As long as more information is available, GPs may ask pregnant patients if they have an history of ADHD or if they plan to take medication in the perinatal period.
A growing number of studies have revealed that most women can safely continue their ADHD medication during pregnancy and breastfeeding. In the end, more and more patients opt to do this, and in consultation with their doctor they have discovered that the benefits of keeping their current medication outweigh any risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help women with ADHD recognize their symptoms and underlying disorder Learn about the available treatments and to reinforce existing strategies for coping. This should be a multidisciplinary process including obstetricians, GPs, and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration, and, if necessary adjustments to the medication regimen.