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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect a foetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who use ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have the necessary data to give clear guidelines but they can provide information about risks and benefits that aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not face a significantly increased risk of fetal cardiac malformations or major birth defects that are structural. The researchers used a large population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure accurate classification of the cases and to reduce the possibility of bias.

However, the study had its limitations. Researchers were unable, in the first place, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to the use of medications or caused by co-morbidities. Additionally the study did not study the long-term outcomes of offspring.

The study did find 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 those who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk for admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.

Women who were taking stimulant ADHD medication for autism and adhd during pregnancy were also at an increased risk of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

Researchers suggest that the small risk of using adhd sleep medication medications during early pregnancies may be offset by the greater benefits to both baby and mother of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies to improve coping skills that can lessen the negative impact of her condition on her daily life and relationships.

Medication Interactions

Many doctors are faced with the decision of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are frequently made without clear and reliable evidence. Instead, physicians must weigh their own knowledge, the experience of other physicians and the research on the subject.

The issue of possible risks to infants is particularly tricky. Many of the studies on this issue are based on observations instead of controlled research and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which could underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing information on deceased and live 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 found no connection, and most studies have a neutral or slight negative effect. In the end an accurate risk-benefit analysis is required in every situation.

It can be difficult, if not impossible for women with ADHD to stop taking their medication. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation and family conflict for patients with ADHD. Furthermore, a loss of medication can affect the ability to perform job-related tasks and drive safely, which are important aspects of a normal life for many people suffering from ADHD.

She suggests that women who aren't sure whether to continue taking medication or stop due to pregnancy should educate family members, colleagues, and acquaintances about the condition, the impact on daily functioning and the benefits of keeping the current treatment. It can also help a woman feel confident about her decision. It is also worth noting that certain drugs can pass through the placenta, therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be transferred to the infant.

Risk of Birth Defects

As the use of adhd medication online medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about the effects that the drugs might have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Utilizing two huge data sets researchers were able to analyze more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the scientists discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).

The authors of the study found no connection between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in agreement with previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication before the birth of their child. The risk was higher in the latter half of pregnancy, as many women are forced to stop taking their ADHD medication.

Women who used ADHD medication in the first trimester of pregnancy were also more likely to undergo a caesarean section, a low Apgar score after delivery and a baby who needed breathing assistance at birth. The authors of the study were not able to remove bias in selection since they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope their study will help inform the clinical decisions of doctors who encounter pregnant women. They recommend that, while discussing risks and benefits is important but the decision to stop or maintain treatment should be based on each woman's needs and the severity of her ADHD symptoms.

The authors also warn that while discontinuing the medications is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health issues in women who are pregnant or postpartum. Further, research shows that women who stop taking their medication will have a difficult time adjusting to a life without them after the baby is born.

Nursing

It can be overwhelming becoming a mother. Women with ADHD who have to manage their symptoms while attending physician appointments, making preparations for the arrival of a child and adapting to new routines in the home can experience severe challenges. Many women opt to continue taking their Adhd Medication Pregnancy medication during pregnancy.

The majority of stimulant medications pass through breast milk in small amounts, so the risk to infant who is breastfeeding is low. The rate of medication exposure will vary based on the dosage the medication is administered, its frequency and the time of the day. In addition, various medications enter the baby’s system via the gastrointestinal tract or breast milk. The impact on a newborn's health is not completely comprehended.

Because of the lack 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 benefits of continuing her medication with the potential dangers to the embryo. As long as there is no more information, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal period.

Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, a growing number of patients are opting to continue their medication. They have concluded after consulting with their physicians, that the benefits of continuing their current medication outweigh possible risks.

Women with adhd treatment medication who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD recognize their symptoms and the underlying disorder Learn about the available treatments and to reinforce existing strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if necessary adjustments to the medication regime.