Many Of The Most Exciting Things That Are Happening With ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these drugs may affect the fetus.

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

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication need to consider the benefits of taking it against the possible dangers for the foetus. Doctors don't have the data needed to give clear guidelines, but they can provide information on risks and benefits that assist pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not face a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was correct and to eliminate any bias.

However, the study was not without its flaws. Most important, they were unable to distinguish the effects of the medication from the effects of the disorder that is underlying. This limitation makes it difficult for researchers to establish whether the few associations observed between the groups that were exposed to the use of medications, or if they were affected by co-morbidities. In addition the study did not look at long-term offspring outcomes.

The study found that babies whose mothers took ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the increased risk for admission was not found to be influenced by which stimulant medication was used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medication during pregnancies in the early stages could be offset by the greater benefits to both mother and baby from continuing treatment for the woman's condition. Physicians should speak with their patients about this issue and as much as possible, assist them develop coping skills that could reduce the impact of her disorder in her daily life and relationships.

Medication Interactions

Many doctors are confronted with the dilemma of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are often made without clear and authoritative evidence. Instead, doctors must consider their own expertise and experience, as well as the experiences of other doctors and the research on the subject.

The issue of possible risks to the infant can be difficult to determine. A lot of studies on this topic are based on observational evidence rather than controlled research and their findings are often contradictory. Most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study presented in this journal club addresses these limitations by looking at data from both live and deceased births.

Conclusion Some studies have revealed an association 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, effect. Therefore an accurate risk-benefit analysis is required in every instance.

For many women with ADHD who suffer from ADHD, the decision to stop taking medication is difficult, if not impossible. In a recent article in the 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. In addition, a decrease in medication can affect the ability to complete job-related tasks and drive safely which are essential aspects of daily life for many people suffering from ADHD.

She suggests that women who aren't sure whether to take the medication or stop due to pregnancy should educate family members, coworkers and friends about the condition, its impact on daily functioning and the benefits of continuing the current treatment. Educating them can also 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 therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug can be transferred to the child.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. With two massive data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.

The researchers behind the study found no connection between the use of early medications and congenital abnormalities like facial clefting, or club foot. The findings are in line with previous studies that have shown an increase, but not significant, in the risk of developing cardiac malformations among women who started taking ADHD medications 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 pregnancies were also more likely to have a caesarean section, a low Apgar score after delivery and a baby who required breathing assistance during birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could have contributed to the findings.

The researchers hope their research will help inform the clinical decisions of physicians who see pregnant women. They recommend that, while a discussion of the benefits and risks is important but the decision to stop or continue treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also warn that, while stopping the medication is an option, it is not an option that is recommended due to the high rate of depression and other mental health problems for women who are expecting or postpartum. Additionally,  medication for adhd in adults  suggests that women who stop taking their medications will have a tough adjustment to life without them once the baby is born.

Nursing

It can be a stressful experience to become a mom. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments, getting ready for the arrival of their child and getting used to new routines at home can experience severe challenges. Many women choose to continue taking their ADHD medication during pregnancy.

The majority of stimulant medications are absorbed through breast milk in low quantities, so the risk for infant who is breastfeeding is low. The amount of exposure to medications can vary depending upon the dosage the medication is administered, its frequency and the time of day. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't fully known.

Because of the lack of research, some doctors may be inclined to discontinue stimulant drugs during a woman's pregnancy. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the possible risks to the foetus. Until more information becomes available, GPs can inquire about pregnant patients whether they have an history of ADHD or if they plan to take medication in the perinatal stage.

A increasing number of studies have proven that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. In the end, more and more patients opt to do this, and in consultation with their doctor they have found that the benefits of continuing their current medication far outweigh any potential risks.

It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand their symptoms and underlying disorder and learn about treatment options and reinforce existing strategies for managing. This should be a multidisciplinary process with the GPs, obstetricians and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both mother and child, as well as monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.