ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and nursing is a challenge for women suffering from the condition. There aren't enough data on how long-term exposure may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to
adhd without medication 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 research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of taking them against the potential risks to the foetus. Doctors don't have the necessary data to make unequivocal recommendations however they can provide information on the risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants in the early stages of pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure correct classification of the cases and to reduce the chance of bias.
The study conducted by the researchers was not without its limitations. Researchers were unable, in the first place to distinguish the effects of the medication from the disorder. This 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 study did not look at long-term offspring outcomes.
The study showed that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission was not found to be influenced by the stimulant medications were taken during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean section or having a baby with a low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
The research suggests 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 from continued treatment for the woman's condition. Doctors should discuss with their patients about this and, if possible, help them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to continue treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of clear and authoritative evidence either way, so physicians must weigh what they know about their experiences, the experiences of other doctors, and
what is the most common adhd medication prescribed research says on the topic and their own best judgment for each individual patient.
The issue
Types Of Adhd Medication risk for infants can be difficult to determine. A lot of studies on this topic are based on observational data rather than controlled research and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
The conclusion is that while some studies have found an association between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship, and most studies show a neutral or even slightly negative effect. Therefore, a careful risk/benefit assessment is required in every situation.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In fact, 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. A decrease in medication could also affect the ability to safely drive and perform work-related tasks, which are crucial aspects of normal life for people with ADHD.
She suggests that women who are not sure whether to take the medication or stop due to pregnancy educate family members, coworkers and friends about the condition, the effects on daily functioning, and the benefits of keeping the current treatment plan. It can also aid in ensuring that the woman feels supported in her struggle with her decision. It is also worth noting that some medications are able to be absorbed through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be transferred to the infant.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers utilized two massive data sets to examine more than 4.3 million pregnancies and determine if stimulant medication use increased 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, like ventriculo-septal defects (VSD).
The researchers of the study did not find any association between the use of early medications and congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that have shown an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of the birth of their child. This risk increased during the latter part of pregnancy, as many women are forced to stop taking their ADHD medications.
Women who took ADHD medications in the first trimester of their pregnancies were also more likely to have a caesarean section, a low Apgar score following delivery, and a baby who needed breathing assistance during birth. The authors of the study were unable to remove bias in selection since they restricted the study to women with no other medical conditions that might have contributed to the findings.
Researchers hope that their research will provide doctors with information when they see pregnant women. The researchers recommend that, while discussing the risks and benefits are crucial, the decision on whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her requirements.
The authors warn that, although stopping the medication is an option to look into, it is not advised because of the high incidence of depression and other mental problems for women who are pregnant or have recently given birth. Additionally, the research suggests that women who choose to stop taking their medication are more likely to experience a difficult time adjusting to life without them following the baby's arrival.
Nursing
It can be a challenge becoming a mother. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments, preparing for the arrival of a baby and adjusting to new household routines can experience severe challenges. Therefore, many women elect to continue taking their ADHD medications throughout the course of pregnancy.
The majority of stimulant medications pass through breast milk in very small amounts, so the risk for nursing infant is very low. However, the amount of exposure to medication by the newborn may differ based on dosage, how often it is administered, and at what time the medication is administered. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn is not well understood.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant drugs during the course of pregnancy. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the potential dangers to the fetus. Until more information becomes available, doctors
can i get adhd medication without a diagnosis inquire about pregnant patients if they have any history of
get adhd medication online or if they intend to take medication during the perinatal phase.
Numerous studies have proven that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. As a result, an increasing number of patients opt to do this and, after consulting with their doctor, they have discovered that the benefits of continuing their current medication exceed any risk.
It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD be aware of their symptoms and underlying disorder, learn about available treatments and to reinforce existing strategies for managing. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatrists. Counselling for pregnancy should include discussion of a management plan for both the mother as well as the child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.