ADHD Medication During Pregnancy and Breastfeeding

Women suffering from adult adhd medication uk face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these medications could affect the foetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as 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 expecting and taking ADHD medication should weigh the benefits of taking it versus the risks for the foetus. Physicians do not have the necessary data to provide clear recommendations but they can provide information about benefits and risks that can aid 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 birth defects that are structural. Researchers used a vast, population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was correct and to eliminate any bias.

However, the researchers' study had its limitations. In particular, they were not able to differentiate the effects of the medication from those of the disorder at hand. This makes it difficult to determine whether the small associations observed in the groups that were exposed are due to medication use or confounding by comorbidities. Additionally the researchers did not study long-term offspring outcomes.

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

Women who were taking stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean section or having a child with low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the small risk of using ADHD medications in early pregnancies can be offset by greater benefits for mother and baby of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies to improve their coping abilities which can reduce the impact of her disorder on her daily functioning and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to maintain treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are taken in the absence of solid and reliable evidence either way, so physicians must weigh their knowledge, the experiences of other doctors, and what research suggests about the subject and their own judgments for each patient.

In particular, the issue of possible risks to the baby can general practitioners prescribe adhd medication be a challenge. Many of the studies on this issue are based on observational evidence rather than controlled research and their conclusions are often contradictory. The majority of studies focus on live-births, which could underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these limitations by analyzing data on live and deceased births.

Conclusion Some studies have revealed an association between ADHD medications and certain birth defects however, other studies haven't established a link. The majority of studies show that there is a neutral, or slightly negative, impact. As a result an accurate risk-benefit analysis is required in every instance.

For a lot of women with ADHD who can prescribe medication for adhd suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In an article published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for these patients. Furthermore, a loss of medication can affect the ability to do work-related tasks and safely drive that are crucial aspects of a normal life for many people with ADHD.

She suggests women who are uncertain about whether or not to stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily functioning, and the advantages of continuing the current treatment regimen. It can also help a woman feel supported in her decision. Certain medications can be passed through the placenta. If a patient decides to not take her adhd no medication medication while pregnant and breastfeeding, it is important to be aware that the medication could be passed on to her infant.

Birth Defects and Risk of

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns over the impact that these drugs might have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Using two massive data sets researchers were able to examine more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects like ventriculo-septal defects (VSD).

The authors of the study could not find any association between the use of early medications and congenital anomalies like facial deformities, or club feet. The results are in the same vein as previous studies that have shown an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. The risk was higher in the later part of pregnancy, when many women decide to stop taking their ADHD medications.

Women who took ADHD medication during the first trimester were more likely require a caesarean delivery or have a low Apgar after birth and have a baby that needed help breathing after birth. However the researchers of the study were not able to eliminate selection bias by limiting the study to women who did not have any other medical conditions that could have contributed to the findings.

Researchers hope their research will inform physicians when they meet pregnant women. They advise that while the discussion of the benefits and risks is important, the decision to stop or continue medication should be based on the woman's needs and the severity of her ADHD symptoms.

The authors caution that, although stopping the medication is a possibility to think about, it isn't recommended because of the high incidence of depression and other mental disorders in women who are expecting or who have recently given birth. Further, the research suggests that women who choose to stop taking their medication are more likely to have difficulties adjusting to life without them following the birth of their baby.

Nursing

The responsibilities of being a new mother can be overwhelming. Women with ADHD can face severe challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs are absorbed by breast milk in small amounts, therefore the risk for nursing infant is very low. The rate of medication exposure will differ based on dosage, frequency of administration and time of day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not yet fully understood.

Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman, who must weigh the benefits of her medication against the risk to the embryo. Until more information becomes available, GPs may inquire about pregnant patients whether they have a history of ADHD or if they plan to take medication in the perinatal stage.

A growing number of studies have revealed that women can continue to take their ADHD medication For odd and adhd while they are pregnant and nursing. In response, a growing number of patients are choosing to do so. They have discovered after consulting with their physicians that the benefits of keeping their current medication far outweigh any potential risks.

It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also be educated about treatment options and build strategies for coping. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration and, if necessary modifications to the medication given for adhd regimen.