ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how exposure to ADHD for a long time could 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 research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking Adhd medication pregnancy,
minecraftcommand.Science, medications need to balance the advantages of using them against the risks to the fetus. Doctors don't have the necessary data to make unequivocal recommendations, but they can provide information on the risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at a greater risk of fetal malformations or structural birth defects. Researchers used a vast population-based study of case-control to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants in the early stages of pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate case classification and to limit the chance of bias.
However, the study was not without its flaws. The researchers were not able, in the first place to distinguish the effects caused by the medication from the disorder. This makes it difficult for researchers to determine if the small associations observed among the groups exposed were due to medication use or affected by comorbidities. In addition, the researchers did not study the long-term outcomes of offspring.
The study did show 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 infants who whose mothers did not take any medication or cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean section or having a child with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefit for both mother and child of continuing treatment for the woman's condition. Doctors should discuss with their patients about this and as much as possible, assist them develop coping strategies that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the issue of whether or not to end treatment during pregnancy is one that doctors are having to face. Most of the time, these decisions are made in the absence of solid and reliable evidence either way, so physicians must weigh their knowledge, the experiences of other doctors, and what research suggests on the subject, along with their best judgment for each individual patient.
In particular, the issue of potential risks for the baby can be tricky. A lot of studies on this subject are based on observational data rather than controlled research and their findings are often contradictory. Most studies focus on live births, which may underestimate the severity of teratogenic effects leading 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.
The conclusion The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no connection, and
most common adhd medication uk studies have a neutral or slightly negative impact. In all cases an in-depth evaluation of the risks and benefits must be performed.
It isn't easy, but not impossible, for women with
adhd medication making it worse to stop taking their medication. In a recent article in the 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 those suffering from the disorder. The loss of medication can affect the ability to drive safely and to perform work-related tasks which are essential aspects of everyday life for those suffering from ADHD.
She suggests that women who are unsure about whether to keep or stop taking medication because of their pregnancy, consider informing family members, friends and colleagues on the condition, its effects on daily functioning, and the advantages of continuing the current treatment regimen. In addition, educating them can aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the medication could be transferred to the infant.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (
adhd inattentive type medication), increases as does the concern about the possible effects of the drugs on foetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Utilizing two huge data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.
The authors of the study could not find any association between early use of medication and congenital anomalies like facial deformities, or club feet. The results are consistent with previous studies showing a small but significant increase in the risk of heart malformations in women who started taking ADHD medications prior to the time of pregnancy. The risk grew during the latter part of pregnancy, when a lot of women decide to stop taking their ADHD medications.
Women who took ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby who needed breathing assistance at birth. However the researchers of the study were not able to eliminate bias due to selection by limiting the study to women who did not have any other medical issues that could have contributed to these findings.
Researchers hope that their study will provide doctors with information when they meet pregnant women. The researchers recommend that while discussing risks and benefits are important, the decision on whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her needs.
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 problems among women who are pregnant or who are recently post-partum. Additionally, the research suggests that women who choose to stop taking their medication are more likely to experience difficulties getting used to life without them after the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments as well as preparing for the arrival of a child and adjusting to
new adhd medication uk household routines may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed by breast milk in very small amounts, so the risk to breastfeeding infant is minimal. The rate of exposure to medication will vary based on the dosage, frequency of administration and time of day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn infant is not fully understood.
Due to the absence of evidence, some doctors may be inclined to discontinue stimulant medications during a woman's pregnancy. It is a difficult decision for the woman, who must weigh the benefits of her medication against the risk to the fetus. In the meantime, until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal period.
Many studies have shown that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. As a result, an increasing number of patients opt to do this, and in consultation with their doctor they have discovered that the benefits of continuing their current medication far outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also learn about treatment options and strengthen the coping mechanisms. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if needed, adjustments to the medication regimen.
