ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how long-term exposure may affect the pregnant fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental disorders like hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are needed.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication must evaluate the benefits of using it versus the dangers for the baby. Physicians do not have the data needed to make unequivocal recommendations however they can provide information on the risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large sample-based case control study to assess the frequency of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure correct case classification and to limit the possibility of bias.

However, the study had its limitations. Researchers were unable in the beginning, to separate the effects of the medication from the disorder. This makes it difficult to determine whether the small differences observed in the exposed groups are due to medication use or the confounding effect of comorbidities. In addition the study did not examine long-term offspring outcomes.

The study did reveal that babies whose mothers had taken ADHD medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without 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 medications during pregnancy also had a higher risk of having to have an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases didn't 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 early pregnancy may be offset by the higher benefit to both the mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, if possible, help them develop strategies for improving their coping with adhd without medication skills which can reduce the effects of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever are diagnosed with adhd medication pregnancy (visit this link) and being treated with medication, the question of whether to continue or end treatment during pregnancy is a question that doctors are having to face. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must consider their own expertise and experience, as well as the experiences of other physicians and the research on the topic.

The issue of potential risks to the infant can be extremely difficult. A lot of studies on this topic are based on observations rather than controlled research and their findings are often contradictory. The majority of studies focus on live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study presented in this journal club addresses these issues by examining data on both live and deceased births.

The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no connection and the majority of studies demonstrate a neutral or slight negative effect. In the end an accurate risk-benefit analysis must be done in each situation.

For many women with ADHD and ADD, the decision to stop taking medication is difficult, if not impossible. In an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping getting adhd medication uk medication during pregnancy can increase depression, feelings of isolation, and family conflict for patients with adhd medication list. A decrease in medication could affect the ability to drive safely and complete work-related tasks, which are essential aspects of daily life for people with ADHD.

She suggests that women who aren't sure whether to continue taking the medication or stop it due to their pregnancy educate family members, coworkers, and their friends about the condition, the effects on daily functioning, and the benefits of keeping the current treatment. It can also help a woman feel more confident in her decision. Certain medications can pass through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it is important to be aware that the drug could be passed on to her baby.

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 about what impact the medications could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two huge data sets to study more than 4.3 million pregnancy and determine if stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increased risk of certain heart defects, such as ventriculoseptal defect (VSD).

The researchers of the study did not find any association between early medication usage and other congenital anomalies like facial deformities or club feet. The findings are in line with previous studies showing the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to pregnancy. The risk increased in the latter half of pregnancy, when a lot of women decided to stop taking their medication.

Women who took ADHD medications in the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who required help breathing at birth. However the researchers of the study were not able to eliminate bias due to selection by limiting the study to women who didn't have any other medical conditions that could be a contributing factor to these findings.

Researchers hope that their study will help doctors when they meet pregnant women. They recommend that, while discussing the risks and benefits is crucial however, the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors caution that, although stopping the medication is an option to look into, it is not recommended because of the high incidence of depression and other mental disorders in women who are expecting or have recently given birth. Furthermore, research suggests that women who decide to stop their medications are more likely to experience a difficult time adjusting to life without them after the baby's arrival.

Nursing

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

The majority of stimulant medicines pass through breast milk in very small amounts, so the risk for nursing infant is very low. However, the frequency of exposure to medication by the newborn may differ based on the dosage, frequency it is taken and at what time the medication 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 fully understood.

Because of the lack of research, some doctors may be inclined to discontinue stimulant medications during the course of pregnancy. It's a difficult choice for the mother, who must weigh the advantages of her medication against the risk to the fetus. In the meantime, until more information is available, GPs may inquire about pregnant patients if they have a background of ADHD or if they are planning to take medication in the perinatal stage.

A growing number of studies have proven that most women can safely continue their strongest adhd medication for adults medication during pregnancy and while breastfeeding. This has led to many patients choose to do so, and in consultation with their doctor they have found that the benefits of keeping their current medication far outweigh any potential risks.

Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and strengthen strategies for coping. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration and, if needed adjustments to the medication regime.