What The Heck What Exactly Is ADHD Medication Pregnancy?

What The Heck What Exactly Is ADHD Medication Pregnancy?

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ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect the pregnant fetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological disorders like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication should weigh the benefits of taking it against the potential risks to the foetus. The doctors don't have the information to provide clear recommendations but they can provide information on risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to ensure that the classification was accurate and to reduce any bias.

The study of the researchers was not without limitations. The researchers were not able in the beginning to distinguish the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the few associations observed between the exposed groups were due to the use of medication or affected by co-morbidities. Researchers also did not study long-term outcomes for offspring.

The study revealed that infants whose mothers had taken ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission did not appear to be influenced by the stimulant medications were taken during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher chance of having a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases 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 more beneficial outcomes for both baby and mother of continued treatment for the woman's condition. Doctors should discuss with their patients about this and try to help them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and being treated with medication, the dilemma of whether or not to end treatment during pregnancy is one that more and more physicians have to face. The majority of these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh what they know from their own experiences, those of other doctors, and what research suggests about the subject, along with their best judgment for each patient.

In particular, the issue of possible risks to the baby can be tricky. A lot of studies on this topic are based on observational evidence rather than controlled research and their conclusions are often contradictory. Most studies focus on live-births, which could underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.

Conclusion Some studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not established a link. Most studies show a neutral, or even slightly negative, impact. In each case an in-depth evaluation of the benefits and risks must be performed.

For women suffering from ADHD, the decision to stop medication is difficult if not impossible. 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 loneliness, and family conflict for those suffering from the disorder. The loss of medication can also impact the ability to drive safely and to perform work-related tasks which are essential aspects of normal life for those suffering from ADHD.

She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy, educate their family members, colleagues, and acquaintances about the condition, the effects on daily functioning, and the benefits of keeping the current treatment plan. Educating them can also help the woman feel supported as she struggles with her decision. Some medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication may be transferred to her baby.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns over the impact that these drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two huge datasets to analyze over 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).

The authors of the study found no link between early use of medication and other congenital anomalies, 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 began taking ADHD medications prior to pregnancy. The risk was higher during the latter part of pregnancy, when a lot of women begin to discontinue their medication.

Women who used 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 who required breathing assistance at birth. The researchers of the study could not remove bias in selection since they limited the study to women with no other medical conditions that might have contributed to the findings.

Researchers hope that their study will help doctors when they meet pregnant women. They advise that while discussing the benefits and risks is important however, the decision to stop or keep medication should be based on each woman's requirements and the severity of her ADHD symptoms.

The authors caution that, while stopping the medication is a possibility to think about, it isn't advised due to the high prevalence of depression and other mental disorders for women who are pregnant or recently gave birth. Further, the research suggests that women who decide to stop their medications are more likely to experience difficulties getting used to life without them after the birth of their baby.

Nursing

It can be a challenge to become a mom. Women with ADHD can face severe challenges when they must manage their symptoms, attend click here doctor appointments, 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 majority of stimulant medicines pass through breast milk in small amounts, so the risk for infant who is breastfeeding is low. The rate of medication exposure can vary depending upon the dosage and frequency of administration as well as time of day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn isn't yet fully understood.

Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. It's a difficult choice for the woman who must weigh the advantages of her medication against the risk to the embryo. Until more information becomes available, GPs may inquire about pregnant patients if they have an history of ADHD or if they intend to take medication during the perinatal phase.

Numerous studies have demonstrated that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. In response, a growing number of patients are opting to do so. They have found, in consultation with their physicians, that the benefits of continuing their current medication far outweigh any possible risks.

It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help women with ADHD understand their symptoms and the root cause, learn about available treatment options and reinforce existing strategies for coping. This should involve a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother as well as the child, and monitoring for signs of deterioration, and the need for adjustments to the medication regimen.