ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and nursing is challenging for women with the condition. There aren't many studies on
how adhd medication works long-term exposure may affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental disorders like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the benefits of taking them against potential risks to the fetus. Doctors don't have the data needed to give clear guidelines but they can provide information regarding risks and benefits that aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face an 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 babies born to mothers who had taken stimulants during the early stages of pregnancy and those
who can prescribe adhd medication had not. 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.
The study conducted by the researchers was not without its limitations. The researchers were unable to, in the first place to distinguish the effects triggered by the medication from the disorder. This limitation makes it difficult to know whether the limited associations observed in the groups that were exposed result from medication use or comorbidities that cause confusion. The researchers also did not look at long-term outcomes for the offspring.
The study showed that infants whose mothers took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the increased risk of admission was not found to be influenced by which stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases didn't appear to be influenced by the kind of medication used during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD
medications used for adhd in early pregnancies may be offset by the greater benefits for baby and mother of continued treatment for the woman's condition. Physicians should discuss this with their patients and, where possible, help them develop strategies to improve their coping abilities that may minimize the negative impact of her condition on her daily life and 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 stop treatment during pregnancy is one that more and more physicians have to face. Most of the time, these decisions are made in the absence of clear and authoritative evidence in either case, which means that doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests on the subject and their own judgments for each individual patient.
The issue of risk to the infant can be extremely difficult. Many of the studies on this topic are based on observations rather than controlled research and their conclusions are often contradictory. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues by analyzing the data from deceased and live births.
The conclusion is that while some studies have shown an association between ADHD medications and the possibility of certain birth defects, other studies have found no connection, and most studies show a neutral or even slightly negative impact. In all cases it is imperative to conduct a thorough evaluation of the potential risks and benefits is required.
For many women with ADHD, the decision to stop taking medication is difficult, if not impossible. In fact, in an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for those suffering from the disorder. In addition, a decrease in medication can interfere with the ability to complete work-related tasks and safely drive that are crucial aspects of daily life for many people with
adhd medication pregnancy.
She recommends women who are uncertain about whether to keep or discontinue medication due to their pregnancy consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment plan. In addition, educating them can aid in ensuring that the woman feels supported as she struggles with her decision. Some medications 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 may be transferred to her baby.
Risk of Birth Defects
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the medications could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Researchers utilized two massive data sets to study more than 4.3 million pregnant women and determine if stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The researchers of the study found no link between early medication use and other congenital anomalies, such as facial clefting or club foot. The findings are in line with previous studies showing the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking ADHD medications before the birth of their child. The risk was higher during the latter part of pregnancy, when many women decide to stop taking their ADHD medications.
Women who took ADHD medications during the first trimester of pregnancy were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance during birth. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who didn't have any other medical conditions that could have contributed to the findings.
Researchers hope that their study will help doctors when they encounter pregnant women. The researchers suggest that while discussing risks and benefits are crucial, the decision regarding whether or not to stop taking medication should be based on the severity of each woman's ADHD symptoms and her requirements.
The authors also caution that even though stopping the medication is an option, it is not a recommended practice because of the high incidence of depression and other mental health issues for women who are expecting or recently post-partum. Furthermore, research suggests that women who decide to stop their medications are more likely to have a difficult time adjusting
how to get medication for adhd uk life without them after the baby's arrival.
Nursing
The responsibilities of being a new mom can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed through breast milk in low amounts, so the risk to the infant who is breastfeeding is low. However, the frequency of exposure to medications by the newborn
can i get adhd medication without a diagnosis vary depending on dosage, frequency it is taken and the time of the day the medication is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn infant is not well understood.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must balance the benefits of keeping her medication against the potential risks to the embryo. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether they are planning or taking to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, an increasing number of patients are choosing to do this. They have concluded after consulting with their doctor that the benefits of continuing their current medication outweigh possible risks.
It's important for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and strengthen the coping mechanisms. This should be a multidisciplinary process with the GPs, obstetricians, and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration, and, if necessary adjustments to the medication regimen.
