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ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or continue ADHD medications during pregnancy and breastfeeding is challenging for women with the condition. There isn't much information on how does medication for adhd work long-term exposure to these drugs could affect the fetus.

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

Risk/Benefit Analysis

Pregnant women who use ADHD medications need to balance the advantages of using them against the risks to the foetus. Physicians don't have the information needed to give clear guidelines, but they can provide information about the risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an higher 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 babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was accurate and to reduce any bias.

However, the researchers' study was not without its flaws. Researchers were unable in the beginning to distinguish the effects caused by the medication from the disorder. This makes it difficult for researchers to determine if the few associations observed between the groups exposed were due to medication use, or if they were confounded by comorbidities. The researchers also did not study the long-term effects for the offspring.

The study showed that infants whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers didn't take any medication for adhd 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 affected by the type of stimulant medications were taken during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases didn't seem to be influenced by the kind of medication used during pregnancy.

The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child of continuing treatment for the woman's condition. Physicians should talk to their patients about this and try to help them improve coping skills which may reduce the impact of her disorder in her daily life and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are taken in the absence of solid and reliable evidence in either case, which means that doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what medication is prescribed for adhd the research suggests about the subject and their best judgment for each individual patient.

The issue of potential risks for infants can be difficult to determine. The research on this issue is based on observations rather than controlled studies and many of the findings are contradictory. Furthermore, most studies restrict their analysis to live births, which could undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both data on live and deceased births.

The conclusion is that while some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies have a neutral or slightly negative impact. In the end, a careful risk/benefit assessment is required in every situation.

For women suffering from ADHD and ADD, the decision to stop medication is difficult, if not impossible. In a recent article 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 isolation. In addition, a decrease in medication can interfere with the ability to complete job-related tasks and drive safely, which are important aspects of a normal life for many people suffering from ADHD.

She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy, educate their family members, coworkers and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment regimen. It can also help a woman feel supported in her decision. It is also worth noting that certain medications can be absorbed through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be transferred to the child.

Risk of Birth Defects

As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (adhd and anxiety medication), increases, so does concern about the potential effects of these drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers utilized two massive data sets to examine more than 4.3 million pregnant women and determine if the use of stimulant medications caused birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The researchers of the study found no association between early use of medication and other congenital anomalies, such as facial clefting or club foot. The results are consistent with previous studies that have shown the presence of a small, but significant increase in the risk of cardiac malformations among women who started taking ADHD medications prior to the time of pregnancy. The risk grew in the latter half of pregnancy, as many women decide to stop taking their ADHD medications.

Women who were taking ADHD medication during the first trimester were more likely to need a caesarean and also have a low Apgar after delivery and have a baby who needed breathing assistance when they were born. 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 that their research will serve to inform the clinical decisions of physicians who see pregnant women. They advise that while the discussion of the risks and benefits is crucial but the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms.

The authors caution that, even though stopping the medication is a possibility to think about, it isn't recommended because of the high incidence of depression and other mental problems among women who are pregnant or who have recently given birth. Research has also shown that women who stop taking their medication will have a difficult adjustment to life without them after the baby is born.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women who suffer from safest adhd medication for adults who must work through their symptoms while attending physician appointments and getting ready for the arrival of their child and adjusting to new household routines may face a lot of challenges. This is why many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The risk for nursing infant is low because the majority of stimulant medications is absorbed through breast milk at low levels. The amount of exposure to medications will vary based on the dosage the medication is administered, its frequency and time of day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn infant is not fully known.

Because of the lack of research, some physicians may be inclined to discontinue stimulant medications during a woman's pregnancy. This is a difficult decision for the woman, who must weigh the advantages of her medication against the risk to the foetus. Until more information becomes available, GPs can ask pregnant patients whether they have a background of ADHD or if they intend to take medication in the perinatal stage.

Many studies have shown that women can continue taking their ADHD medication in a safe manner during pregnancy and while breast-feeding. In response, an increasing number of patients are opting to continue their medication. They have discovered through consultation with their doctors that the benefits of continuing their current medication outweigh any potential risks.

It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication 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 and learn about treatment options and reinforce existing coping strategies. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration, and, if necessary modifications to the medication regime.