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 is a lack of information about how long-term exposure to these medications may affect the foetus.
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 more high quality research is needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the benefits of taking them against the potential risks to the foetus. The doctors don't have the information to give clear advice but they can provide information on risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large sample-based case control study to compare the incidence of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was accurate and to eliminate any bias.
The study of the researchers had some limitations. The researchers were unable to, in the first place, to separate the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the few associations observed between the groups that were exposed to medication use, or if they were caused by co-morbidities. Researchers also did not study long-term outcomes for the offspring.
The study found that infants whose mothers took ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the higher risk of admission was not found to be affected by the type of stimulant medication was 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 did appear to be independent of the type of medication used during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit for both mother and child from continued treatment for the woman's disorder. Physicians should discuss this with their patients and, when possible, assist them in developing strategies to improve their coping abilities that may minimize the impact of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the dilemma of whether or not to end treatment during pregnancy is a question that more and more doctors face. These decisions are usually made without clear and authoritative evidence. Instead, doctors must take into account their own experience and experience, as well as the experiences of other physicians and the research on the subject.
More Signup bonuses of risk to the infant can be extremely difficult. Many of the studies on this subject are based on observational data 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 presented in the journal club addresses these issues by analyzing information on deceased and live births.
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 not found any evidence of a link, and most studies have a neutral or slightly negative effect. In every case, a careful study of the risks and benefits must be performed.
It can be challenging, if not impossible, for women with ADHD to stop taking their medication. 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 increase depression, feelings of loneliness and family conflict for these patients. In addition, a decrease in medication may affect the ability to perform jobs and drive safely that are crucial aspects of daily life for many people suffering from ADHD.
She suggests 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 about the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. It can also help women feel supported in 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 may be transferred to her infant.
Birth Defects and Risk of
As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers utilized two massive data sets to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.
The authors of the study didn't discover any connection between early use of medication and other congenital anomalies, like facial deformities or club feet. The results are in the same vein as previous studies which showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the birth of their child. This risk increased during the latter part of pregnancy when a large number of women began to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely need a caesarean or have a low Apgar after delivery, and have a baby who needed breathing assistance at birth. The researchers of the study were not able to eliminate selection bias because they limited their study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope their study will help inform the clinical decisions of doctors who encounter pregnant women. The researchers suggest that, while discussing the risks and benefits are important, the choice regarding whether or not to stop medication should be based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also advise that while discontinuing the medications is an option, it isn't an option to consider due to the high prevalence of depression and other mental health issues among women who are pregnant or who are recently postpartum. Research has also shown that women who stop taking their medications will have a difficult transitioning to life without them once the baby is born.
Nursing
The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at a low level. However, the amount of medication exposure to the infant can differ based on dosage, how often it is administered and at what time the medication is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not well known.
Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the woman who must weigh the benefits of continuing her medication against the risk to the fetus. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time.
A increasing number of studies have shown that women can continue taking their ADHD medication during pregnancy and while breastfeeding. This has led to many patients are choosing to do so and in consultation with their physician, they have found that the benefits of continuing their current medication far outweigh any risks.
Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should be a multidisciplinary process with the GPs, obstetricians and psychiatry. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.