ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There aren't many studies regarding how exposure over time may affect a fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are needed.

Risk/Benefit Analysis

Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the fetus. Physicians do not have the information needed to give clear guidelines but they can provide information about benefits and risks that can assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who used 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 large population-based study of case control 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 an accurate classification of the cases and to reduce the possibility of bias.

The research conducted by the researchers was not without limitations. The most important issue was that they were unable to separate the effects of the medication from the disorder at hand. This limitation makes it difficult to know whether the small differences observed in the exposed groups result from medication use or confounding by comorbidities. The researchers also did not study long-term outcomes for offspring.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system 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 medication during pregnancy were also at an increased risk of having a caesarean delivery or having a child with an low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies may be offset by the greater benefits for baby and mother of continued treatment for the woman’s disorder. Doctors should discuss with their patients about this issue and, if possible, help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships.

Medication Interactions

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

Particularly, the subject of possible risks to the baby can be tricky. The research that has been conducted on this topic is based on observation instead of controlled studies and a lot of the results are contradictory. In addition, most studies limit their analysis to live births, which can a doctor prescribe adhd medication without a diagnosis undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues, by examining both information on deceased and live births.

Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies show an unintended, or slight negative effect. In each case an in-depth analysis of the risks and benefits must be performed.

It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent piece 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 being isolated. A loss of medication may also affect the ability to safely drive and complete work-related tasks, which are vital aspects of daily life for those with ADHD.

She suggests that women who are unsure whether to take the medication or stop due to pregnancy should educate family members, colleagues, and friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment plan. It will also help a woman feel more confident in her decision. Some medications can pass through the placenta. If a patient decides not to take her adhd medication pregnancy (https://images.google.co.za/url?q=https://writeablog.net/quincebath11/the-secret-secrets-of-managing-adhd-without-medication) medication while breastfeeding, it is important to be aware that the medication could be transferred to the baby.

Risk of Birth Defects

As the use and misuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing as does the concern about the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. With two massive data sets researchers were able examine more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).

The researchers of the study didn't discover any connection between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of pregnancy. This risk increased during the latter part of pregnancy, when a lot of women begin to discontinue their ADHD medications.

Women who used ADHD medications during the first trimester of their pregnancies were also more likely to have a caesarean section, a low Apgar score following delivery, and a baby who required help breathing at birth. The researchers of the study were not able to eliminate bias due to selection because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope their study will serve to inform the clinical decisions of doctors who encounter pregnant women. They recommend that, while discussing the risks and benefits is crucial, the decision to stop or keep treatment must be based on each woman's needs and the severity of her ADHD symptoms.

The authors also caution that, while stopping the medication is an alternative, it is not an option that is recommended due to the high incidence of depression and other mental health problems among women who are pregnant or recently postpartum. Further, research shows that women who stop taking their medication for inattentive adhd and anxiety will have a tough adjustment to life without them once the baby is born.

Nursing

It can be a challenge to become a mother. Women with ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at a low level. However, the rate of exposure to medication by the infant can differ based on dosage, frequency it is administered and the time of day it is administered. Additionally, different medications enter the baby's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn infant is not well understood.

Some doctors may decide to stop stimulant medications used for adhd during a woman's pregnancy due to the lack of research. This is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risk to the foetus. In the meantime, until more information is available, GPs can inquire about pregnant patients if they have an history of ADHD or if they are planning to take medication during the perinatal stage.

A increasing number of studies have shown that the majority of women are able to safely continue to take their ADHD medication during pregnancy and breastfeeding. In the end, many patients are choosing to do so, and after consulting with their doctor, they have discovered that the benefits of maintaining their current medication exceed any risk.

It's important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and reinforce coping mechanisms. This should involve a multidisciplinary approach with the GP, obstetricians and psychiatry. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, as well as monitoring for signs of deterioration, and the need for adjustments to the medication regimen.