adhd and depression medication (supplemental resources) Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision on whether to keep or stop taking adhd medication guide medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these medications can affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the advantages of using them against the risks to the fetus. Physicians don't have the data to make unambiguous recommendations however they can provide information on the risks and benefits to assist pregnant women to make an informed decision.

A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a massive sample-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate case classification and to limit the chance of bias.

The study conducted by the researchers was not without limitations. The researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. That limitation makes it difficult to know whether the limited associations observed in the exposed groups result from medication use or the confounding effect of comorbidities. In addition the researchers did not look at the long-term outcomes of offspring.

The study revealed that infants whose mother took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These risks did not appear to be influenced 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 early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, assist them in developing strategies to improve their coping abilities that can lessen the impact of her disorder on her daily functioning and relationships.

Medication Interactions

As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is one that more and more physicians confront. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors must weigh their own knowledge and experience, as well as the experiences of other doctors and the research on the topic.

The issue of possible risks to infants is extremely difficult. The research on this subject is based on observations rather than controlled studies, and many of the findings are in conflict. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing information on deceased and live births.

Conclusion Some studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show a neutral, or even somewhat negative, effect. In all cases it is imperative to conduct a thorough analysis of the risks and benefits should be conducted.

For women suffering from ADHD who suffer from ADHD, the decision to discontinue medication can be difficult, if not impossible. In a recent piece published in the 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. Furthermore, a loss of medication may affect the ability to do work-related tasks and safely drive which are essential aspects of daily life for many people suffering from ADHD.

She suggests that women who are not sure whether to take the medication or stop it due to their pregnancy, educate their family members, colleagues, and friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment. It can also make the woman feel more comfortable as she struggles with her decision. It is important to note that some medications are able to be absorbed through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug can be transferred to the child.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about what impact the medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Researchers utilized two massive data sets to examine over 4.3 million pregnancy and determine if the use of stimulant medications increased birth defects. Researchers discovered that although the overall risk is low, the first trimester adhd medication without diagnosis uk exposure to medication was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.

The researchers of the study could not discover any connection between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are in line with previous studies that have shown 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, as many women begin to discontinue their medication.

Women who took ADHD medication in the first trimester were more likely need a caesarean, have a low Apgar after delivery and have a baby that needed help breathing at birth. The researchers of the study could not eliminate bias due to selection because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope their research will serve to inform the clinical decisions of physicians who see pregnant women. They suggest that although a discussion of the risks bipolar and adhd medication benefits is crucial, the decision to stop or continue treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, even though stopping the medication is an option to consider, it is not advised due to the high rate depression and mental health issues for women who are pregnant or who have recently given birth. Research has also shown that women who stop taking their medications will have a tough time adjusting to a life without them after the baby is born.

Nursing

It can be a challenge to become a mom. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments as well as making preparations for the arrival of their child and adjusting to new household routines are often faced with a number of difficulties. Many women decide to continue taking their ADHD medication during pregnancy.

The risk to a breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk at a low level. The rate of medication exposure will differ based on dosage and frequency of administration as well as the time of day. In addition, various drugs enter the infant's system via the gastrointestinal tract or breast milk. The impact on the health of a newborn isn't completely known.

Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. It is a difficult decision for the mother, who must weigh the benefits of her medication against the risks to the embryo. As long as more information is available, GPs can inquire about pregnant patients if they have an background of ADHD or if they plan to take medication in the perinatal period.

A growing number of studies have revealed that most effective adhd medication for adults women can safely continue taking their ADHD medication while they are pregnant and nursing. This has led to an increasing number of patients opt to do this, and in consultation with their physician, they have found that the benefits of keeping their current medication far exceed any risk.

Women with ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant people with ADHD recognize their symptoms and the root cause, learn about available treatments and to reinforce existing strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for indicators of deterioration, and, if necessary modifications to the medication regime.