ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data regarding how exposure over time may affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to
adhd medication in uk medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to consider the benefits of taking it versus the dangers for the fetus. Physicians don't have the data to provide clear recommendations, but can provide information about risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking
natural adhd medication medication during early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers used a large population-based study of case control to compare the incidence of structural defects that were major in infants born to mothers who 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 reduce any bias.
However, the study had its limitations. In particular, they were unable to distinguish the effects of the medication from those of the disorder that is underlying. This makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to the use of medication or if they were caused by the presence of comorbidities. The researchers also did not look at long-term outcomes for the offspring.
The study found that babies whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to mothers who did not take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This was due to central nervous system-related disorders, and the increased risk for admission did not appear to be affected by the type of stimulant medications were used during pregnancy.
Women who took stimulant
strattera adhd medication medications during pregnancy also had a higher likelihood of having to have an emergency caesarean section or having 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.
Researchers suggest that the minor risks associated with the use ADHD medication during pregnancies in the early stages may be offset by the greater benefits for baby and mother of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if 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 question of whether to continue or stop treatment during pregnancy is one that more and more physicians face. These decisions are usually made without clear and reliable evidence. Instead, physicians must weigh their own knowledge in conjunction with the experiences of other physicians and the research on the topic.
Particularly, the issue of possible risks to the baby can be a challenge. The research on this issue is based on observations rather than controlled studies, and a lot of the results are contradictory. Most studies restrict their analysis to live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these shortcomings by analyzing data on live and deceased births.
Conclusion A few studies have shown a positive correlation between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies have shown an unintended, or slight negative effect. In all cases, a careful study of the potential risks and benefits should be conducted.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of being isolated. Additionally, the loss of medication can affect the ability to complete jobs and drive safely which are essential aspects of a normal life for many people with ADHD.
She recommends women who are uncertain about whether or not to stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and the advantages of staying on the current treatment regimen. It can also help women feel supported in her decision. Some medications can pass through the placenta. If a woman decides not to take her
private adhd assessment medway Adhd medication cost (
Http://linkic.Co.kr/bbs/board.php?bo_table=free&wr_id=474523) medication while breastfeeding, it is important to be aware that the medication could be passed on to her infant.
Birth Defects Risk
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as does the concern about the potential effects of these drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Utilizing two huge data sets, researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects like ventriculo-septal defects (VSD).
The researchers of the study found no link between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are consistent with previous studies revealing an increase, but not significant, in the risk of heart malformations among women who began taking ADHD medications before the time of pregnancy. The risk grew in the latter half of pregnancy, when many women decide to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely to need a caesarean, have a low Apgar after birth and had a baby that required help breathing at birth. The researchers of the study were unable to remove bias in selection since they restricted the study to women without other medical conditions that might have contributed to the findings.
Researchers hope that their research will inform physicians when they meet pregnant women. The researchers advise that, while discussing the risks and benefits are important, the choice on whether to continue or stop medication should be made according to the severity of each woman's ADHD symptoms and her requirements.
The authors caution that, while stopping the medication is an option to consider, it is not advised because of the high incidence of depression and other mental disorders for women who are pregnant or who have recently given birth. Further, research shows that women who stop taking their medication will have a harder time adjusting to a life without them once the baby is born.
Nursing
The responsibilities of a new mother can be overwhelming. Women with ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to new routines. As such, many women decide to continue taking their ADHD medications throughout pregnancy.
The risk for nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. The amount of exposure to medications will vary based on the dosage the medication is administered, its frequency and time of day. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The impact on the health of a newborn isn't fully known.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult decision for the woman, who must weigh the benefits of continuing her medication against the risk to the embryo. Until more information is available, GPs should ask all pregnant patients about their history of ADHD and whether they plan or are taking to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue taking their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, a growing number of patients are opting to continue their medication. They have found, in consultation with their doctors, that the benefits of keeping their current medication far outweigh any possible risks.
It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and build strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both the mother as well as the child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.
