ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these drugs could affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental conditions like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must consider the benefits of taking it against the potential risks for the baby. Physicians don't have the data to provide clear recommendations however they can provide information on the risks and benefits to assist pregnant women to make informed decisions.
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 conducted a massive sample-based case control study to assess the frequency of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure accurate case classification and to limit the possibility of bias.
However, the study was not without its flaws. The researchers were unable to, in the first place, to separate the effects caused by the medication from the disorder. This makes it difficult to determine whether the small associations observed in the groups that were exposed result from medication use or confounding by comorbidities. Additionally the study did not study long-term offspring outcomes.
The study did find 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 whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both mother and child of continuing treatment for the woman's disorder. Doctors should discuss with their patients about this issue and try to help them improve coping skills which may reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of any evidence that is clear and definitive either way, so physicians must weigh what they know, the experiences of other doctors, and what research suggests on the subject, along with their own best judgment for each individual patient.
Particularly, the issue of potential risks for the baby can be tricky. The research on this issue is based on observation rather than controlled studies, and the results are conflicting. Most studies focus on live-births, which could underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing data on live and deceased births.
The conclusion The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies demonstrate a neutral or slightly negative effect. In all cases it is imperative to conduct a thorough evaluation of the potential risks and benefits must be performed.
It can be challenging, if not impossible, for women with 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 cause depression and feelings of loneliness. In addition, a decrease in medication can affect the ability to complete job-related tasks and drive safely that are crucial aspects of a normal life for many people suffering from ADHD.
She suggests women who are uncertain about whether or not to discontinue medication due to their pregnancy consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and on the advantages of staying on the current treatment regimen. In addition, educating them can make the woman feel more comfortable as she struggles with her decision. Certain medications can be passed through the placenta. If the patient decides not to take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication could be transferred to the infant.
Birth Defects Risk
As the use and use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the potential effects of these drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers utilized two massive datasets to analyze over 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect.
The researchers behind the study found no link between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are consistent with previous studies revealing an increase, but not significant, in the risk of developing cardiac malformations among women who started taking ADHD medications before the birth of their child. The risk increased in the latter half of pregnancy when many women decided to stop taking their medication.
Women who took ADHD medications in the first trimester of their pregnancy were also more likely to experience caesarean section, low Apgar score following delivery, and a baby that required breathing assistance during birth. The researchers of the study were unable to eliminate selection bias because they restricted the study to women without other medical conditions that might have contributed to the findings.
Researchers hope their research will inform physicians when they encounter pregnant women. They advise that while discussing risks and benefits is important, the decision to stop or maintain treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also caution that even though stopping the medication is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health issues among women who are pregnant or recently postpartum. Research has also shown that women who stop taking their medications will have a tough transitioning to life without them after 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 deal with their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. Therefore, many women choose to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines are absorbed through breast milk in low amounts, therefore the risk to breastfeeding infant is minimal. However, the frequency of medication exposure to the newborn may differ based on dosage, how often it is administered, and at what time it is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn is not well known.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult choice for the patient, who must weigh the benefits of continuing her medication against the possible dangers to the embryo. As long as more information is available, GPs may inquire about pregnant patients whether they have an background of ADHD or if they are planning to take medication in the perinatal stage.
A increasing number of studies have shown that women can continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are choosing to do this. They have discovered after consulting with their physicians that the benefits of continuing their current medication outweigh risk.
adhd adults medication is crucial for women suffering from ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the root cause, learn about available treatments and to reinforce existing coping strategies. This should be a multidisciplinary process including obstetricians, GPs and psychiatrists. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.