ADHD Medication During Pregnancy and Breastfeeding

Women with 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 may affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication should weigh the benefits of taking it versus the risks for the baby. Physicians do not have the data needed to provide clear recommendations but they can provide information about benefits and risks that can help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their 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 evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants in the early stages of pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure correct case classification and to limit the possibility of bias.

However, the study was not without its flaws. The most important issue was that they were unable to distinguish the effects of the medication from the disorder that is underlying. This makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or comorbidities that cause confusion. In addition the study did not look at the long-term outcomes of offspring.

The study showed that infants whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy or had stopped taking their medication before or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean delivery or having a baby with low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

over the counter adhd medication researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the greater benefits for both mother and child of continued treatment for the woman's condition. Physicians should discuss this with their patients and, when they are able, assist them in developing strategies to improve coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.

Interactions with Medication

As more women than ever before are being 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. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors must consider their own expertise, the experience of other physicians and the research that has been conducted on the subject.

The issue of risk for infants can be particularly tricky. Many studies on this topic are based on observations rather than controlled research and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study presented in the journal club addresses these shortcomings by analyzing the data from deceased and live births.

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 connection and the majority of studies show a neutral or even slightly negative impact. In the end, a careful risk/benefit analysis must be conducted in every case.

For women suffering 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 medication adults ADHD medications during pregnancy can lead to depression and feelings of loneliness. A loss of medication may also impact the ability to drive safely and to perform work-related tasks which are vital aspects of everyday life for those suffering from ADHD.

She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy, educate their family members, colleagues, and their friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment plan. Educating them can also aid in ensuring that the woman feels supported when she is struggling with her decision. It is also worth noting that certain drugs can be absorbed through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug could be transferred to the child.

Risk of Birth Defects

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about the effects that the drugs might have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. With two massive data sets researchers were able to look at more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects such as ventriculoseptal defect (VSD).

The authors of the study didn't discover any connection between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are in the same vein as previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the birth of their child. The risk was higher during the latter part of pregnancy, when many women are forced to stop taking their ADHD medications.

Women who used ADHD medication in the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who needed help breathing at birth. The authors of the study were unable to remove bias in selection since 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 choice on whether to continue or stop 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 an option to consider, it is not advised because of the high incidence of depression and other mental disorders in women who are expecting or have recently given birth. Additionally, research suggests that women who stop taking their medication will have a harder adjustment to life without them once the baby is born.

Nursing

The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. This is why many women decide to continue taking their ADHD medications throughout pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The rate of medication exposure will vary based on the dosage the medication is administered, its frequency and the time of day. In addition, various medications enter the baby’s system via the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not completely comprehended.

Some doctors may stop taking stimulant medication during a woman's pregnancy due to the lack of research. This is a complicated decision for the patient, who must weigh the benefits of keeping her medication with the potential dangers to the fetus. In the meantime, until more information is available, GPs should ask all pregnant patients about their history of ADHD and whether they are taking or planning to take medication during the perinatal time.

A growing 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 response, an increasing number of patients are opting to do so. They have concluded after consulting with their physicians, that the benefits of continuing their current medication far outweigh any possible risks.

Women with adhd medication intuniv who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help women with adhd Medication without Prescribing be aware of their symptoms and the root cause, learn about available treatments and to reinforce existing strategies for managing. This should include a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, as well as monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regime.