This Week s Top Stories About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data regarding how exposure over time may affect a pregnant fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like 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 using them against the risks to the fetus. Physicians don't have the data to provide clear recommendations however they can provide information on risks and benefits to aid pregnant women in making an informed decision.
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 cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate classification of the cases and to reduce the possibility of bias.
The research conducted by the researchers had some limitations. Researchers were unable in the beginning, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the small differences observed between the groups exposed were due to the use of medications, or if they were affected by the presence of comorbidities. The researchers did not examine long-term outcomes for the offspring.
The study did show that babies whose mothers had taken ADHD medications during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had taken off their medication 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 medication that was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having caesarean sections or a baby that scored low on the Apgar scale (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies to improve coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is one that doctors are having to confront. Often, these decisions are made without clear and authoritative evidence either way, so physicians have to weigh their experience, the experiences of other doctors, and what the research suggests about the subject, along with their own best judgment for each individual patient.
In particular, the issue of possible risks to the baby can be tricky. The research on this subject is based on observation rather than controlled studies and many of the findings are in conflict. Additionally, the majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.
Conclusion A few studies have shown a positive correlation between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. The majority of studies show a neutral, or even somewhat negative, effect. In the end an accurate risk-benefit analysis is required in every instance.
It can be challenging, if not impossible, for women suffering from 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 most effective adhd medication for adults medication during pregnancy can increase depression, feelings of isolation, and family conflict for patients with ADHD. A decrease in medication could affect the ability to drive safely and complete work-related tasks, which are vital aspects of everyday life for those with getting Adhd medication uk.
She suggests women who are unsure about whether or not to stop medication in light of their pregnancy consider informing family members, friends and colleagues on the condition, its effects on daily life, and the advantages of continuing the current treatment regimen. Educating them can also help the woman feel supported when she is struggling with her decision. It is important to remember that some drugs can be absorbed through the placenta so if the patient decides to stop taking her adhd and anxiety medication medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be passed on to the baby.
Risk of Birth Defects
As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the potential adverse effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. Researchers used two massive datasets to analyze over 4.3 million pregnancy and determine whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects such as ventriculo-septal defect (VSD).
The authors of the study did not discover any connection between early medication usage 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 heart malformations in women who started taking adhd medication without prescribing medications prior to the time of the birth of their child. This risk increased during the latter half of pregnancy when a large number of women stopped taking their medication.
Women who were taking ADHD medication during the first trimester were more likely require a caesarean birth and also have a low Apgar after delivery and had a baby that required help breathing when they were born. The researchers of the study were not able to eliminate bias due to selection because they limited the study to women with no other medical conditions that could have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of physicians who encounter pregnant women. They advise that while a discussion of risks and benefits is important, the decision to stop or maintain treatment should be based on each woman's requirements and the severity of her ADHD symptoms.
The authors caution that, although stopping the medication is an option to consider, it is not recommended due to the high prevalence of depression and mental health issues in women who are expecting or have recently given birth. Further, the research suggests that women who choose to stop taking their medication are more likely to have difficulties adapting to life without them after the birth of their baby.
Nursing
It can be overwhelming becoming a mother. Women suffering from buy adhd medication uk are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant drugs pass through breast milk in low amounts, therefore the risk to the nursing infant is very low. However, the rate of exposure to medication by the newborn may differ based on dosage, frequency it is administered, and the time of day the medication is administered. Additionally, different medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isn't fully known.
Because of the lack of evidence, some doctors may recommend stopping stimulant medication during a woman's pregnancy. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the potential dangers to the foetus. Until more information becomes available, doctors can inquire about pregnant patients if they have an background of ADHD or if they are planning to take medication in the perinatal stage.
A growing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication during pregnancy and while breastfeeding. As a result, an increasing number of patients opt to do this and, in consultation with their doctor they have discovered that the benefits of maintaining their current medication exceed any risk.
Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons of continuing treatment. This includes non prescription adhd medication uk-pharmacological strategies. Psychoeducation should also be provided to help women with ADHD recognize their symptoms and the root cause Learn about the available treatment options and reinforce existing strategies for managing. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, and monitoring for signs of deterioration, and the need for adjustments to the medication regimen.