ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies on how does medication for adhd work long-term exposure may affect the foetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental disorders like hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who use ADHD medications need to balance the benefits of using them against the risks to the fetus. Doctors don't have the necessary data to provide clear recommendations but they can provide information about risks and benefits that assist pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to make sure that the classification was correct and to eliminate any bias.

However, the study was not without its flaws. In particular, they were unable to separate the effects of the medication from the disorder at hand. This limitation makes it difficult for researchers to establish whether the small associations observed among the groups that were exposed to medication use, or if they were caused by co-morbidities. In addition the researchers did not examine the long-term effects of offspring on their parents.

The study did show that infants whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or stopped their medications before or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean birth or having a baby with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication used 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 benefits to both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this issue and as much as possible, assist them improve coping skills which can lessen the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests about the subject as well as their own best judgment for each patient.

The issue of risk for infants can be particularly tricky. The research on this subject is based on observations rather than controlled studies, and a lot of the results are conflicting. The majority of studies limit their analysis to live-births, which could underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these issues, by examining both information on deceased and live births.

Conclusion Some studies have revealed an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown that there is a neutral, or somewhat negative, impact. In each case it is imperative to conduct a thorough study of the potential risks and benefits must be performed.

It isn't easy, but not impossible for women with ADHD to stop taking their medication. In fact, in an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for those suffering from the disorder. A decrease in medication could also affect the ability to drive safely and to perform work-related tasks which are crucial aspects of everyday life for those with ADHD.

She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. Educating them can also make the woman feel more comfortable in her struggle with her decision. Certain medications can be passed through the placenta. If a woman decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug may be transferred to her infant.

Risk of Birth Defects

As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases, so does concern about the potential adverse effects of the drugs on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Using two massive data sets researchers were able to analyze more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects such as ventriculoseptal defect (VSD).

The researchers behind the study found no connection between early medication use and other congenital anomalies, such as facial clefting or club foot. The findings are in line with previous studies revealing the presence of a small, but significant increase in the risk of heart malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. The risk increased in the latter half of pregnancy when many women decided to stop taking their medication.

Women who took ADHD medication in the first trimester of their pregnancy were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who required 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 without other medical conditions that could have contributed to the findings.

Researchers hope that their research will inform physicians when they see pregnant women. The researchers recommend that while discussing the risks and benefits are crucial, the decision on whether to continue or stop taking medication should be in light of the severity of each woman's adhd medication pregnancy symptoms and the needs of the woman.

The authors caution that, even though stopping the medication is a possibility to think about, it isn't advised due to the high rate depression and other mental problems for women who are pregnant or recently gave birth. Additionally, research suggests that women who stop taking their medications will have a harder time adjusting to a life without them once the baby is born.

Nursing

It can be overwhelming to become a mom. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.

The risk to a breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk at a low level. However, the frequency of medication exposure to the newborn can vary depending on dosage, frequency it is taken and the time of day the medication is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn isn't yet fully known.

Because of the lack of research, some doctors may be inclined to discontinue stimulant medication during the course of pregnancy. This is a difficult choice for the patient, who must balance the benefits of continuing her medication against the potential risks to the fetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during over the counter adhd medication uk perinatal time.

A increasing number of studies have proven that women can continue taking their ADHD medication during pregnancy and while breastfeeding. In the end, more and more patients are choosing to do so and in consultation with their doctor they have discovered that the benefits of continuing their current medication outweigh any risks.

Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons of continuing treatment. This includes non stimulant adhd medication list-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce strategies for coping with adhd without medication. This should involve an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counselling should include the discussion of a treatment plan for both mother and child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.