ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data on how long-term exposure may affect a fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like 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 pregnant and take ADHD medication need to weigh the benefits of taking it versus the risks to the foetus. Physicians don't have the information needed to make unequivocal recommendations however they can provide information regarding risks and benefits that help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a massive sample-based case control study to examine the prevalence of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure accurate case classification and to minimize the chance of bias.
However, the researchers' study had its limitations. Researchers were unable in the beginning to distinguish the effects of the medication from the disorder. This makes it difficult for researchers to determine if the few associations observed between the groups exposed were due to medication use or caused by comorbidities. In addition the researchers did not study long-term offspring outcomes.
The study revealed 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 those whose mothers did not use any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases didn't seem to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both mother and child of continuing treatment for the woman's condition. Doctors should discuss with their patients about this issue
bipolar and adhd medication try to help them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are taken in the absence of solid and reliable evidence regardless, so doctors have to weigh their experience from their own experiences, those of other doctors, and what research suggests about the subject and their own best judgment for each patient.
Particularly, the subject of potential risks for the baby can be a challenge. A lot of studies on this subject are based on observations rather than controlled research, and their findings are often contradictory. In addition, most studies limit their analysis to live births, which can underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
Conclusion A few studies have shown an association between ADHD medications and certain birth defects, other studies have not established a link. Most studies show an unintended, or slightly negative, effect. In the end an accurate risk-benefit analysis is required in every case.
It isn't easy, but not impossible for women suffering from 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
buy adhd medication Online uk medication during pregnancy can lead to increased depression, feelings of loneliness and family conflict for these patients. A loss of medication may affect the ability to safely drive and complete work-related tasks, which are vital aspects of normal life for those suffering from ADHD.
She recommends women who are unsure about whether or not to stop medication in light of their pregnancy, consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily functioning, and on the advantages of staying on the current treatment regimen. It can also aid in ensuring that the woman feels supported as she struggles with her decision. Certain
medications used for adhd can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it is important to be aware that the drug could be passed on to her infant.
Risk of Birth Defects
As the use and misuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Using two massive data sets researchers were able examine more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The researchers of the study found no connection between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in line with previous studies which showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the birth of their child. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth and also have a low Apgar after delivery, and have a baby that needed help breathing at birth. The authors of the study could not remove bias in selection since they limited their study to women with no other medical conditions that could have contributed to the findings.
The researchers hope their study will help inform the clinical decisions of physicians who see pregnant women. They advise that while the discussion of the risks and benefits is crucial, the decision to stop or continue treatment should be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also caution that, while stopping the medication is an option, it is not an option that is recommended due to the high prevalence of depression and other mental health problems among women who are pregnant or who are recently postpartum. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience difficulties adapting to life without them after the birth of their baby.
Nursing
It can be a stressful experience becoming a mother. Women suffering from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. Therefore, many women choose to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small quantities, so the risk to the infant who is breastfeeding is low. The rate of medication exposure will differ based on dosage the medication is administered, its frequency and the time of the day. Additionally, different medications enter the baby’s system via the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not completely comprehended.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant medications during a woman's pregnancy. This is a complicated decision for the patient, who must weigh the benefits of continuing her medication with the potential risks to the embryo. In the meantime, until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time.
Many studies have shown that women can continue to take their ADHD medication without risk during pregnancy and while breast-feeding. In the end, many patients choose to do so, and after consulting with their doctor, they have found that the benefits of maintaining their current medication outweigh any potential risks.
Women who suffer from
cheapest adhd medication who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatrists. Pregnancy counselling should include the discussion of a plan for management for both the mother and child, as well as monitoring for signs of deterioration, and the need for adjustments to the medication regimen.
