What NOT To Do In The ADHD Medication Pregnancy Industry
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. Little data exists about how long-term exposure to these drugs can affect the fetus.
A recent study 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 that further high-quality studies are required.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to evaluate the benefits of using it against the possible risks for the foetus. The doctors don't have the information to provide clear recommendations however they can provide information about risks and benefits to assist pregnant women to make informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers used a large population-based case control study to assess the frequency of major structural defects in infants who were born to mothers who prescribes adhd medication (read article) were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was correct and to minimize any bias.
However, the researchers' study had its limitations. The most important issue was that they were not able to differentiate the effects of the medication from the underlying disorder. That limitation makes it difficult to know whether the small associations observed in the exposed groups result from medication use or comorbidities that cause confusion. Researchers also did not study long-term outcomes for the offspring.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be influenced by which stimulant medications were taken during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean delivery or having a baby with an low Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used 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 for mother and baby of 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 effects of her disorder on her daily functioning and her relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or end treatment during pregnancy is one that more and more physicians have to face. Often, these decisions are taken in the absence of clear and authoritative evidence either way, so physicians must weigh what they know, the experiences of other doctors, and what research suggests about the subject and their own best judgment for each individual patient.
Particularly, the issue of possible risks to the baby can be a challenge. The research that has been conducted on this topic is based on observations rather than controlled studies and the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which may underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations by analyzing both data on live and deceased births.
The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative impact. In every case an in-depth evaluation of the potential risks and benefits is required.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In fact, in a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for patients with ADHD. In addition, a decrease in medication can affect the ability to do job-related tasks and drive safely, which are important aspects of daily life for many people with ADHD.
She recommends that women who are unsure about whether to keep or stop taking medication because of their pregnancy, consider educating family members, friends and colleagues on the condition, its impact on daily life, and the advantages of staying on the current treatment plan. Educating them can also make the woman feel more comfortable in her struggle with her decision. It is important to remember that certain medications are able to pass through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug could be transferred to the child.
Risk of Birth Defects
As the use of adhd treatment medication medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the drugs might have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Researchers found that while the risk overall is low, the first trimester ADHD exposure to medication was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.
The researchers of the study could not discover any connection between the use of early medications and other 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 in women who started taking ADHD medications prior to the time of pregnancy. The risk grew during the latter part of pregnancy, as many women begin to discontinue their managing adhd without medication 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 delivery, and had a baby that required help breathing when they were born. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope their research will help doctors when they meet pregnant women. The researchers advise that, while discussing the risks and benefits are important, the decision about whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her needs.
The authors caution that, while stopping the medication is a possibility to think about, it isn't recommended due to the high rate depression and other mental problems among women who are pregnant or recently gave birth. Additionally, research suggests that women who stop taking their medications will have a difficult transitioning to life without them once the baby is born.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women with ADHD 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 child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications pass through breast milk in small amounts, therefore the risk for infant who is breastfeeding is low. However, the frequency of exposure to medication by the newborn may differ based on dosage, how often it is administered and the time of day the medication is administered. In addition, different drugs enter the infant's system through the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not fully understood.
Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the lack of research. This is a complicated decision for the patient, who must weigh the benefit of continuing her medication with the potential risks to the foetus. As long as more information is available, doctors can inquire about pregnant patients whether they have an background of ADHD or if they plan to take medication during the perinatal period.
Numerous studies have proven that women can you get adhd medication without a diagnosis uk continue to take their ADHD medication without risk while breastfeeding and during pregnancy. This has led to many patients choose to do so and in consultation with their doctor they have discovered that the benefits of continuing their current medication outweigh any potential risks.
Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatrists. Pregnancy counselling should include discussion of a management plan for both the mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.