ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There are few data on how long-term exposure may affect a fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality research is needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of taking them against the potential risks to the foetus. Doctors don't have enough data to give clear advice but they can provide information about risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers used a vast, population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was correct and to eliminate any bias.
However, the study had its limitations. In particular, they were unable to separate the effects of the medication from the effects of the disorder at hand. This makes it difficult to know whether the small differences observed in the groups that were exposed are due to medication use or confounding by comorbidities. medications for adhd in adults did not study long-term outcomes for the offspring.
The study showed that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who didn't take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission was not found to be influenced by which stimulant medications were used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a child with low Apgar score (less than 7). These increases did appear to be independent of the type of medication used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications in early pregnancies may be offset by the greater benefits to both baby and mother of continued treatment for the woman's condition. Doctors should discuss with their patients about this issue and try to help them develop coping skills that may reduce the effects of her disorder on her daily life and relationships.
Interactions with Medication
As more women than ever are diagnosed with ADHD and being treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is a question that doctors are having to confront. Most of the time, these decisions are made in the absence of clear and authoritative evidence in either case, which means that doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests about the subject, along with their own best judgment for each patient.
Particularly, the subject of potential risks for the infant can be difficult. Many studies on this topic are based on observations rather than controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which can undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues by analyzing the data from deceased and live births.
Conclusion Some studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not established a link. The majority of studies show an unintended, or slightly negative, effect. In all cases an in-depth evaluation of the risks and benefits should be conducted.
For women suffering from ADHD who suffer from ADHD, the decision to stop medication is difficult, if not impossible. In a recent article in 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 isolation. Furthermore, a loss of medication may affect the ability to do jobs and drive safely that are crucial aspects of daily life for many people suffering from ADHD.
She recommends that women who are unsure about whether or not to stop taking medication because of their pregnancy should consider informing family members, friends and colleagues about the condition, its impact on daily life, and the advantages of continuing the current treatment plan. In addition, educating them can make the woman feel more comfortable in her struggle with her decision. It is also worth noting that certain drugs can pass through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be transferred to the infant.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns over the impact that these drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. medication for adult add used two massive datasets to analyze over 4.3 million pregnant women and determine if the use of stimulant medications caused birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.
The researchers behind the study found no link between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in the same vein as previous studies that have shown a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women began to stop taking their medication.
Women who took ADHD medications in the first trimester of their pregnancy were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby that required breathing assistance during birth. The researchers of the study could not eliminate bias due to selection because they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope that their research will help doctors when they see pregnant women. The researchers recommend that, while discussing benefits and risks are important, the decision on whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and the needs of the woman.
The authors warn that, even though stopping the medication is a possibility to think about, it isn't recommended due to the high rate depression and mental health issues among women who are pregnant or have recently given birth. Further, the research suggests that women who decide to stop taking their medications are more likely to experience difficulties adjusting to life without them following the baby's arrival.
Nursing
It can be a stressful experience becoming a mother. Women with ADHD who have to manage their symptoms while attending doctor appointments as well as making preparations for the arrival of their child and adjusting to new household routines can experience severe challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines pass through breast milk in very small quantities, so the risk for nursing infant is very low. However, the rate of medication exposure to the newborn may differ based on dosage, frequency it is taken and the time of the day it is administered. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not yet fully known.
Because of the lack of evidence, some doctors might be tempted to stop taking stimulant drugs during a woman's pregnancy. It is a difficult decision for the woman, who must weigh the advantages of continuing her medication against the risks to the foetus. In the meantime, until more information is available, doctors may ask pregnant patients whether they have a history of ADHD or if they intend to take medication in the perinatal phase.
A increasing number of studies have proven that women can continue taking their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are opting to do this. They have found through consultation with their doctors that the benefits of continuing their current medication outweigh any potential 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, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration and, if necessary, adjustments to the medication regime.