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ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies regarding how exposure over time may affect the 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 more high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who use ADHD medications must weigh the advantages of taking them against the potential risks to the foetus. Physicians don't have the data to give clear advice however they can provide information on the risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a massive population-based study of case control to assess the frequency of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to limit the chance of bias.

The study conducted by the researchers had some limitations. Researchers were unable in the beginning to differentiate the effects of the medication from the disorder. That limitation makes it difficult to determine whether the small associations observed in the groups that were exposed are due to medication use or the confounding effect of comorbidities. Additionally the study did not look at the long-term outcomes of offspring.

The study revealed that infants whose mother had taken ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy, or had stopped taking their medication before or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk for admission did not appear to be influenced by the stimulant medications were used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases appear to be independent of the type of medication used during pregnancy.

The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both the mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, if possible, help them develop strategies to improve coping skills that can lessen the impact of her disorder on her daily functioning and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to continue or stop treatment during pregnancy is a question that doctors are having to face. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors, and the research on the topic.

Particularly, the subject of potential risks for the infant can be difficult. Many studies on this issue are based on observations instead of controlled research and their findings are often contradictory. Additionally, the majority of 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 presented in this journal club addresses these issues by analyzing data on live and deceased births.

The conclusion: While some studies have found an association between strattera adhd medication medications and the possibility of certain birth defects, others have found no such relationship, and most studies demonstrate a neutral or slightly negative effect. In the end, a careful risk/benefit assessment must be done in each case.

It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent article published 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 loneliness. In addition, a decrease in medication can affect the ability to complete jobs and drive safely which are essential aspects of a normal life for a lot of people with ADHD.

She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy, educate their family members, coworkers and their friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment. It can also make the woman feel more comfortable in her struggle with her decision. It is important to remember that some medications are able to be absorbed through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be passed on to the baby.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (adhd medication names uk) increases there are concerns about the effects that the drugs might have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers utilized two massive data sets to study more than 4.3 million pregnancies and determine if the use of stimulant medications increased birth defects. Researchers discovered that although 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 discover any link between the use of early medications and other congenital anomalies such as facial deformities or club feet. The results are in line with previous studies revealing a small but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to the birth of their child. The risk was higher during the latter part of pregnancy, as many women begin to discontinue their ADHD medications.

Women who used ADHD medications during the first trimester of their pregnancies were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby who needed breathing assistance at birth. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who didn't have other medical issues that could be a contributing factor to these findings.

Researchers hope their research will inform physicians when they see pregnant women. The researchers advise that, while discussing the risks and benefits are important, the choice regarding whether or not to stop taking best medication for adhd and anxiety should be 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 think about, it isn't recommended because of the high incidence of depression and mental health issues in women who are expecting or recently gave birth. Additionally, research suggests that women who stop taking their medication will have a tough time adjusting to a life without them after the baby is born.

Nursing

It can be a stressful experience becoming a mother. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments, preparing for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. This is why many women elect to continue taking their ADHD medications throughout pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the frequency of exposure to medications by the newborn may differ based on dosage, how often it is administered and at what medications are prescribed for adhd time it is administered. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn isn't yet fully known.

Some doctors may stop taking stimulant medications during a woman's pregnancy due to the lack of research. It's a difficult choice for the woman who must weigh the advantages of her medication against the risks to the foetus. Until more information becomes available, doctors may ask pregnant patients if they have an background of ADHD or if they plan to take medication in the perinatal period.

Numerous studies have demonstrated that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. As a result, more and more patients choose to do so and in consultation with their doctor they have found that the benefits of maintaining their current medication outweigh any risks.

Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also needed to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also be educated about treatment options and strengthen coping mechanisms. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. Counselling for pregnancy should include discussion of a management plan for both the mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.