ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision 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 medications could affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to evaluate the benefits of using it against the possible dangers for the baby. The doctors don't have the information to give clear advice however they can provide information on the risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major structural birth defects. The researchers used 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 during early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to minimize the chance of bias.
The study of the researchers was not without limitations. The researchers were unable in the beginning to differentiate the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to the use of medication or if they were confounded by co-morbidities. Additionally, the researchers did not examine the long-term effects of offspring on their parents.
The study revealed that babies whose mothers had taken
online adhd medication medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk of admission did not appear to be influenced by which stimulant medications were taken during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean section or having a baby born with an low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the minor risk of using ADHD medications in early pregnancies may be offset by the greater benefits for baby and mother of continued treatment for the woman's disorder. Physicians should speak with their patients about this and try to help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships.
Interactions with Medication
More and more doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other doctors and the research that has been conducted on the subject.
Particularly, the subject of possible risks to the baby can be tricky. The research on this subject is based on observations rather than controlled studies and the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study presented in the journal club addresses these issues by analyzing both data on live and deceased births.
The conclusion is that while some studies have shown a positive association between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies have a neutral or slightly negative effect. In the end, a careful risk/benefit analysis must be done in each case.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In fact, 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 patients with ADHD. In addition, a decrease in medication can interfere with the ability to complete job-related tasks and drive safely, which are important aspects of daily life for a lot of people with ADHD.
She suggests that women who are unsure whether to continue taking the medication or discontinue it due to pregnancy educate family members, colleagues, and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment plan. It can also help women feel supported in her decision. It is important to remember that certain medications are able to be absorbed through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the medication could be passed on to the baby.
Risk of Birth Defects
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (
adhd medication not working) 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 subject. Researchers used two huge data sets to study more than 4.3 million pregnancies and determine whether stimulant medications caused birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.
The researchers of the study didn't discover any link between early medication usage and congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking
intuitive adhd medication medication before the time of pregnancy. The risk increased in the latter stages of pregnancy, when a lot of women stopped taking their medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean birth, have an insufficient Apgar after delivery, and have a baby who needed help breathing at birth. The authors of the study were unable to remove bias in selection since they limited the study to women without other medical conditions that could have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of doctors who encounter pregnant women. The researchers advise that, while discussing the risks and benefits are important, the choice on whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her requirements.
The authors also warn that, while stopping the medication is an option, it isn't a recommended practice because of the high rate of depression and other mental health issues among women who are pregnant or recently post-partum. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience a difficult time adjusting to life without them after the baby's arrival.
Nursing
It can be a challenge becoming a mother. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to
new adhd medication uk routines. Therefore, many women decide to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed through breast milk in low amounts, therefore the risk to the breastfeeding infant is minimal. However, the rate of exposure to medication by the newborn
can a doctor prescribe adhd medication without a diagnosis vary depending on dosage, how often it is administered and the time of day it is administered. In addition, various medications are introduced into the baby's system through the gastrointestinal tract, or through breast milk. The impact on the health of a newborn is not completely understood.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant drugs during the pregnancy of a woman. This is a difficult decision for the mother, who must weigh the benefits of her medication against the risks to the foetus. As long as more information is available, doctors may ask pregnant patients if they have an history of ADHD or if they are planning to take medication in the perinatal phase.
A increasing number of studies have proven that most women can safely continue to take their ADHD medication during pregnancy and while breastfeeding. 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 maintaining their current medication far outweigh any potential risks.
Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for managing. This should be a multidisciplinary process including obstetricians, GPs and psychiatrists. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.