ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies regarding how exposure over time may affect the pregnant fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to evaluate the benefits of using it against the potential dangers for the fetus. Physicians don't have the information needed to give clear guidelines, but they can provide information about the risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers used a large population-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was accurate and to reduce any bias.
The study conducted by the researchers had some limitations. The most important issue was that they were not able to differentiate the effects of the medication from those of the disorder that is underlying. This limitation makes it difficult to determine whether the small associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. In addition, the researchers did not look at the long-term outcomes of 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), compared to those whose mothers didn't take any medication during pregnancy or discontinued taking their medication 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 medications used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean section or having a baby with low Apgar score (less than 7). These increases did not appear to be affected by the type of medication that was used during pregnancy.
The researchers suggest 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 for both mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this issue and try to help them improve coping skills which can lessen the effects of her disorder on her daily functioning and her relationships.
Interactions with Medication
Doctors are increasingly confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are usually made without clear and reliable evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors, and the research on the topic.
Particularly, the issue of potential risks for the infant can be difficult. The research that has been conducted on this topic is based on observations rather than controlled studies and a lot of the results are conflicting. In addition, most studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these shortcomings by analyzing data on live and deceased births.
The conclusion: While certain studies have demonstrated a positive association between ADHD medications and the risk of certain birth defects, others have found no connection, and most studies demonstrate a neutral or slightly negative impact. In adhd medication side effects is imperative to conduct a thorough analysis of the potential risks and benefits should be conducted.
For a lot of women with 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 being isolated. Additionally, the loss of medication may affect the ability to complete jobs and drive safely, which are important aspects of daily life for many people with ADHD.
She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy should educate family members, coworkers, and acquaintances about the condition, its impact on daily functioning and the advantages of staying on the current treatment. adhd medications for adults can also help a woman feel confident about her decision. It is important to note that certain medications are able to pass through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug can be transferred to the child.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the possible effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. adhd medication side effects used two massive data sets to study more than 4.3 million pregnant women and determine if the use of stimulant medications caused birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect.
The researchers of the study found no link between early medication use and congenital abnormalities like facial clefting, or club foot. The results are in line with previous studies that have shown an increase, but not significant, in the risk of heart malformations among women who started taking ADHD medications prior to the time of the birth of their child. The risk was higher in the latter half of pregnancy, when many women begin to discontinue their medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean birth, have an insufficient Apgar after delivery, and have a baby that needed breathing assistance at birth. However the researchers of the study were not able to eliminate selection bias by limiting the study to women who didn't have other medical issues that could have contributed to these findings.
Researchers hope that their research will inform physicians when they encounter pregnant women. They suggest that although the discussion of risks and benefits is important however, the decision to stop or maintain medication should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also warn that while discontinuing the medications is an alternative, it is not an option to consider due to the high incidence of depression and other mental health issues among women who are pregnant or postpartum. Furthermore, research suggests that women who decide to stop their medications are more likely to have difficulties getting used to life without them after the baby's arrival.
Nursing
It can be overwhelming to become a mom. Women suffering from ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. This is why many women elect to continue taking their ADHD medication throughout the pregnancy.
The risk for nursing infant is low because the majority of stimulant medications is absorbed through breast milk at low levels. The rate of exposure to medication can vary depending upon the dosage and frequency of administration as well as time of day. In addition, different drugs enter the infant's system through the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn isn't completely known.
Due to the absence of research, some doctors may be inclined to discontinue stimulant medications during the pregnancy of a woman. This is a difficult decision for the woman who must weigh the benefits of taking her medication as well as 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 are planning to take medication in the perinatal phase.
Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and breast-feeding. In response, an increasing number of patients are opting to do so. They have discovered after consulting with their doctors, that the benefits of retaining their current medication outweigh any possible 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 for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also learn about treatment options and strengthen coping mechanisms. This should involve a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of signs of deterioration, and, if needed, adjustments to the medication regimen.