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ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or continue ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There is a lack of information about how long-term exposure to these medications can affect the foetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that further 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 do not have the necessary data to provide clear recommendations, but they can provide information regarding the risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a massive population-based case control study to examine the prevalence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to limit the possibility of bias.

However, the study was not without its flaws. In particular, they were not able to differentiate the effects of the medication from the disorder that is underlying. This makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to medication use or caused by the presence of comorbidities. Additionally the study did not study long-term offspring outcomes.

The study found that babies whose mothers took managing adhd without medication medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers didn't take any medication during pregnancy, or had 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 medication was used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.

The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's disorder. Physicians should talk to their patients about this issue and, if possible, help them develop coping skills that could reduce the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to continue or end treatment during pregnancy is one that more and more doctors have to face. These decisions are frequently made without clear and reliable evidence. Instead, doctors have to consider their own expertise, the experience of other physicians and the research on the topic.

The issue of possible risks for infants can be particularly tricky. The research on this issue is based on observations rather than controlled studies, and many of the findings are conflicting. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues, by examining both the data from deceased and live 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. The majority of studies show a neutral, or even somewhat negative, impact. Therefore, a careful risk/benefit analysis must be conducted in every case.

For women suffering from ADHD, the decision to discontinue medication is difficult if not impossible. In an article recently published 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. In addition, a decrease in medication can interfere with the ability to do work-related tasks and safely drive that are crucial aspects of daily life for many people suffering from ADHD.

She suggests that women who aren't sure whether to continue taking medication for adhd and anxiety in adults or stop it due to their pregnancy, educate their family members, coworkers and acquaintances about the condition, its impact on daily functioning and the advantages of staying on the current treatment regimen. Educating them can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to remember that some medications are able to pass through the placenta, so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be transferred to the child.

Birth Defects Risk

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns over the impact that these medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. With two massive data sets researchers were able analyze more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. While the overall risk is low, the researchers found that exposure in the first trimester to ADHD medicines was associated with a slightly higher rate of certain heart defects, like ventriculo-septal defects (VSD).

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 agreement with previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of the time of pregnancy. The risk grew in the latter half of pregnancy, when many women are forced to stop taking their medication.

Women who took ADHD medications during the first trimester of pregnancy were also more likely to have caesarean sections, a low Apgar score after delivery and a baby who needed help breathing at birth. The authors of the study were not able to eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings.

Researchers hope their research will provide doctors with information when they see pregnant women. The researchers recommend that, while discussing the risks and benefits are crucial, the decision about whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and the needs of the woman.

The authors warn that, while stopping the medication is an option to look into, it is not recommended due to the high prevalence of depression and other mental problems in women who are expecting or recently gave birth. Further, research shows that women who stop taking their medication will have a difficult time adjusting to a life without them once the baby is born.

Nursing

It can be a stressful experience becoming a mother. Women with ADHD who have to manage their symptoms while attending doctor appointments and making preparations for the arrival of a child and getting used to new routines at home can experience severe challenges. Therefore, many women elect to continue taking their ADHD medication throughout the pregnancy.

The risk to a breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The amount of exposure to medications will differ based on dosage, frequency of administration and the time of the day. In addition, various medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The impact of these medications on a newborn's health is not fully comprehended.

Some physicians may discontinue stimulant medication for adhd during a woman’s pregnancy due to the absence of research. This is a complicated decision for the patient, who must balance the benefits of keeping her medication with the potential dangers to the embryo. Until more information becomes available, doctors can inquire about pregnant patients if they have an history types of adhd medication (https://Www.youtube.com/) ADHD or if they intend to take medication during the perinatal stage.

Numerous studies have proven that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to do so. They have discovered through consultation with their physicians, that the benefits of keeping their current medication far outweigh any potential 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 their medication with their prescriber, and the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder and learn about treatment options and reinforce existing coping strategies. This should be a multidisciplinary effort together with obstetricians, GPs and psychiatry. 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 regime.