ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There are few data regarding how exposure over time may affect the pregnant fetus.

A recent study 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 the need for higher-quality studies.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the benefits of taking them against potential risks to the fetus. Physicians don't have the data to give clear advice however they can provide information about risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to compare the incidence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was correct and to eliminate any bias.

The study conducted by the researchers was not without limitations. In particular, they were unable to separate the effects of the medication from the disorder that is underlying. This limitation makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to the use of medications or if they were confounded by comorbidities. The researchers did not study long-term outcomes for offspring.

The study did reveal that infants whose mothers had taken adhd medication Pregnancy medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk of admission was not found to be influenced by the stimulant medications were used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases appear 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 the early stages of pregnancy could be offset by the greater benefit to both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, help them develop strategies to improve their coping abilities which can reduce the effects of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether to continue or end treatment during pregnancy is one that more and more doctors confront. These decisions are often made without clear and authoritative evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other doctors and the research on the topic.

In particular, the issue of potential risks for the baby can be a challenge. A lot of studies on this topic are based on observations rather than controlled research, and their conclusions 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 discussed in this journal club addresses these limitations by examining data on both live and deceased births.

Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not established a link. Most studies have shown that there is a neutral, or slightly negative, impact. In all cases it is imperative to conduct a thorough evaluation of the benefits and risks is required.

It isn't easy, but not impossible, for women with ADHD 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 loneliness and family conflict for those suffering from the disorder. In addition, a decrease in medication may affect the ability to complete work-related tasks and safely drive which are essential aspects of a normal life for a lot of people with ADHD.

She suggests that women who aren't sure whether to continue taking the medication or discontinue it due to pregnancy should educate family members, coworkers and acquaintances about the condition, the impact on daily functioning and the benefits of continuing the current treatment regimen. It can also help a woman feel confident about her decision. It is also worth noting that certain medications are able to pass through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the medication could be transferred to the infant.

Risk of Birth Defects

As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases as does the concern about the potential adverse effects of the drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Researchers used two huge datasets to analyze over 4.3 million pregnant women and determine whether stimulant medications used for adhd increased the risk of birth defects. Although the risk overall remains low, the scientists did find that first-trimester exposure to ADHD medications was associated with an increase in the risk of certain heart defects such as ventriculo-septal defect (VSD).

The researchers behind the study found no connection between the use of early medications and other congenital abnormalities, such as facial clefting or club foot. The results are in line with previous studies that have shown a small but significant increase in the risk of cardiac malformations in women who started taking adhd treatment medication medications prior to the birth of their child. The risk grew in the later part of pregnancy, when many women begin to discontinue their medication.

Women who took ADHD medication in the first trimester of their pregnancy were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who needed breathing assistance at birth. The researchers of the study were unable to remove bias in selection since they limited their study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope their research will serve to inform the clinical decisions of physicians who see pregnant women. The researchers advise that while discussing benefits and risks are important, the choice regarding whether or not to stop taking medication should be in light of 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 an option to consider due to the high prevalence of depression and other mental health issues in women who are pregnant or who are recently postpartum. Further, the research suggests that women who choose to stop taking their medications are more likely to have difficulties adjusting to life without them after the baby's arrival.

Nursing

It can be a challenge to become a mother. Women with ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to new routines. As such, many women decide to continue taking their ADHD medication throughout the pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk in low amounts. The rate of medication exposure will differ based on dosage the medication is administered, its frequency and the time of day. Additionally, individual 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 well understood.

Because of the lack of research, some physicians may be inclined to discontinue stimulant drugs during the course of pregnancy. This is a difficult decision for the mother, who must weigh the benefits of taking her medication as well as the risk to the foetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with adhd medication online uk and if they are taking or planning to take medication during the perinatal time.

A increasing number of studies have shown that most women can safely continue taking their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are choosing to do so. They have concluded through consultation with their doctor that the benefits of keeping their current medication far outweigh any risk.

Women with ADHD who plan to breastfeed should seek advice from an expert 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 people with ADHD recognize their symptoms and underlying disorder Learn about the available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatrists. Pregnancy counselling should include the discussion of a plan for management for both the mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.