ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these medications could affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental conditions like hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the advantages of taking them against potential risks to the foetus. Doctors don't have the information needed to make unequivocal recommendations but they can provide information regarding the risks and benefits to assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have an increased risk of fetal cardiac 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 had taken stimulants in early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was accurate and to eliminate any bias.

However, the study had its limitations. Researchers were unable, in the first place to distinguish the effects caused by the medication from the disorder. This makes it difficult for researchers to determine whether the small associations observed among the groups that were exposed to the use of medication or if they were confounded by co-morbidities. The researchers did not look at the long-term effects for the offspring.

The study found that infants whose mothers took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was due to central nervous system-related disorders and the increased risk of admission did not appear to be influenced by which stimulant medications were used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a baby with a low Apgar score (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy.

The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit for both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve their coping abilities that may minimize the impact of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether to keep or end treatment during pregnancy is one that more and more physicians confront. Most of the time, these decisions are made without solid and reliable evidence in either case, which means that doctors must weigh what they know, the experiences of other doctors, and what research says on the topic, along with their own judgments for each individual patient.

The issue of risk to infants is difficult to determine. The research on this subject is based on observation instead of controlled studies and a lot of the results are conflicting. In addition, most studies limit their analysis to live births, which could underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by looking at data from both live and deceased births.

The conclusion: While some studies have found a positive association between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link and the majority of studies have a neutral or slightly negative effect. In every case, a careful study of the potential risks and benefits is required.

It can be challenging, if not impossible, for women suffering from adhd medication pregnancy (Read the Full Content) to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. A loss of medication may also impact the ability to safely drive and to perform work-related tasks which are vital aspects of daily life for people with ADHD.

She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider informing family members, friends, and coworkers on the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. Educating them can also aid in ensuring that the woman feels supported in her struggle with her decision. Certain medications can be passed through the placenta. If a woman decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication could be transferred to the infant.

Birth Defects and Risk of

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns over the impact that these drugs could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Utilizing two huge data sets, researchers were able to analyze more than 4.3 million pregnancies and see 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 risk of certain heart defects, like ventriculoseptal defect.

The authors of the study found no connection between early medication use and other congenital anomalies, such as facial clefting or club foot. The results are in agreement with previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. The risk grew during the latter part of pregnancy, when a lot of women are forced to stop taking their ADHD medications.

Women who used ADHD medications in the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score following delivery, and a baby who needed help breathing at birth. The authors of the study were unable to remove bias in selection since they limited their study to women without other medical conditions that might have contributed to the findings.

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

The authors caution that, even though stopping the medication is an option to consider, it is not advised due to the high rate depression and other mental problems among women who are pregnant or have recently given birth. Furthermore, research suggests that women who decide to stop taking their medication are more likely to experience difficulties adapting to life without them following the birth of their baby.

Nursing

The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments as well as getting ready for the arrival of a child and getting used to new routines at home may face a lot of challenges. This is why many women elect to continue taking their ADHD medications throughout pregnancy.

The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at low levels. However, the frequency of exposure to medication by the newborn may differ based on the dosage, frequency it is taken and the time of the day the medication is administered. In addition, different medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The impact on the health of a newborn isn't completely known.

Because of the lack of evidence, some doctors might be tempted to stop taking stimulant medications used for adhd during the course of pregnancy. This is a difficult choice for the patient, who can prescribe medication for adhd must weigh the benefits of continuing her medication against the potential dangers to the foetus. In the meantime, until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether they plan or are taking to take medication during the perinatal period.

A growing number of studies have revealed that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. As a result, an increasing number of patients choose to do so and in consultation with their physician, they have discovered that the benefits of keeping their current medication outweigh any risks.

Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD understand their symptoms and underlying disorder and learn about treatments and to reinforce existing strategies for managing adhd without medication adults. This should include a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if needed, adjustments to the medication regimen.