ADHD Medication Pregnancy 10 Things I d Like To Have Known Sooner
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medication during pregnancy and nursing is a difficult decision for women suffering from the condition. There are few data on how long-term exposure may affect a fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have enough data to make unambiguous recommendations but they can provide information about risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large population-based case control study to assess the frequency of structural defects that were major in infants born to mothers who can prescribe adhd medication for adults were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists looked over the cases to ensure accurate classification of the cases and to reduce the possibility of bias.
However, the researchers' study had its limitations. The researchers were not able in the beginning to distinguish the effects of the medication from the disorder. This makes it difficult for researchers to determine whether the small associations observed among the groups exposed were due to the use of medication or if they were caused by co-morbidities. The researchers also did not look at long-term outcomes for offspring.
The study did reveal that babies whose mothers had taken ADHD medication 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 cut back on their medications prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk for admission was not found 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 an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the minor risks associated with the use ADHD medications in early pregnancies may be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them develop coping skills that can lessen the impact of her disorder in her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or stop treatment during pregnancy is one that more and more physicians face. The majority of these decisions are taken in the absence of 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 the research suggests on the subject and their best judgment for each patient.
The issue of possible risks to infants is extremely difficult. The research on this subject is based on observations rather than controlled studies, and many of the findings are contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study discussed in this journal club addresses these shortcomings by examining data on both live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link, and most studies show a neutral or even slightly negative effect. In every case it is imperative to conduct a thorough analysis of the potential risks and benefits must be performed.
For women suffering from ADHD and ADD, the decision to stop medication can be difficult, if not impossible. In an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping adhd focus medication medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for those suffering from the disorder. Furthermore, a loss types of adhd medication medication may affect the ability to perform job-related tasks and drive safely, which are important aspects of daily life for a lot of 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, colleagues, and friends about the condition, its impact on daily functioning and the benefits of keeping the current treatment regimen. Educating them can also make the woman feel more comfortable in her struggle with her decision. It is important to remember that certain medications can be absorbed through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the medication could be transferred to the child.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns over the impact that these drugs might have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers utilized two massive data sets to study more than 4.3 million pregnancy and determine if the use of stimulant medications caused birth defects. While the overall risk remains low, the researchers found that exposure in the first trimester to ADHD medications was linked to a slightly higher rate of certain heart defects such as ventriculoseptal defect (VSD).
The researchers of the study could not discover any link between early medication usage and other congenital anomalies such as facial deformities or club feet. The results are in the same vein as previous studies that have shown an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the birth of their child. The risk was higher during the latter part of pregnancy, when many women decide to stop taking their ADHD medication.
Women who took ADHD medication in the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after birth and had a baby that required help breathing after birth. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who did not have any other medical issues that could have contributed to the findings.
The researchers hope their research will help inform the clinical decisions of doctors who see pregnant women. The researchers recommend that, while discussing the risks and benefits are crucial, the decision on whether to continue or stop medication should be in light of the severity of each woman's ADHD symptoms and her requirements.
The authors also advise that even though stopping the medication is an option, it is not a recommended practice because of the high incidence 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 taking their medication are more likely to have a difficult time getting used to life without them after the birth of their baby.
Nursing
It Can Doctors Prescribe Adhd Medication be a challenge to become a mom. Women who suffer from ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. As such, many women decide to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medications are absorbed through breast milk in small amounts, therefore the risk to the nursing infant is very low. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and time of day. Additionally, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The effect on the health of a newborn is not completely understood.
Due to the absence of research, some physicians may recommend stopping stimulant medication during the pregnancy of a woman. This is a complicated decision for the patient, who must weigh the benefit of continuing her medication against the possible risks to the fetus. Until more information becomes available, GPs may ask pregnant patients whether they have any history of ADHD or if they plan to take medication during the perinatal period.
A increasing number of studies have proven that women can continue to take their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are opting to do so. They have discovered, in consultation with their doctor that the benefits of continuing their current medication outweigh risk.
Women who suffer from ADHD who are planning to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary effort with the GPs, obstetricians, and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration, and, if needed modifications to the medication regime.