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ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or continue adhd inattentive type medication medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There are few data on how exposure to ADHD for a long time could affect a fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the potential risks for the foetus. Physicians don't have the data to provide clear recommendations, but 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 were taking ADHD medications during early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large population-based study of case control to examine the prevalence of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to ensure that the classification was correct and to minimize any bias.

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

The study found that babies whose mothers took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy or had stopped taking their medication before or during pregnancy. This increase was due to central nervous system disorders, and the increased risk of admission did not appear to be influenced by the stimulant medications were taken during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a baby with an low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

The researchers suggest that the risk of a small amount 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. Doctors should discuss with their patients about this and, if possible, help them develop coping skills that could reduce the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

Many doctors are confronted with the dilemma of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are frequently taken without clear and authoritative evidence. Instead, physicians must weigh their own knowledge, the experience of other doctors, and the research on the subject.

Particularly, the issue of potential risks to the infant can be difficult. Many of the studies on this subject 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 abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing information on deceased and live births.

The conclusion The conclusion: While some studies have shown a positive association between ADHD medications and the risk of certain birth defects, other studies have found no connection, and most studies show a neutral or even slightly negative effect. Therefore, a careful risk/benefit analysis must be conducted in every situation.

For many women with adhd Medication pregnancy, the decision to discontinue medication is difficult if not impossible. In fact, in an article recently published in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping adhd over the counter medication uk medication during pregnancy can increase depression, feelings of loneliness, and family conflict for those suffering from the disorder. Furthermore, a loss of medication can interfere with the ability to complete job-related tasks and drive safely that are crucial aspects of daily life for many people with ADHD.

She suggests women who are uncertain about whether or not to stop taking medication because of their pregnancy consider educating family members, friends and colleagues about the condition, its impact on daily life, and the advantages of continuing the current treatment regimen. In addition, educating them can help the woman feel supported when she is struggling with her decision. Some medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication could be transferred to the infant.

Birth Defects Risk

As the use and misuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases, so does concern about the potential adverse effects of the drugs 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 over 4.3 million pregnancies and determine if stimulant medication use increased birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).

The authors of the study found no link between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The findings are in line with previous studies revealing an increase, but not significant, in the risk of heart malformations among women who began taking ADHD medications before the time of pregnancy. This risk increased during the latter half of pregnancy, when a lot of women stopped taking their medication.

Women who used ADHD medications during the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance during birth. The researchers of the study were not able to remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.

The researchers hope their research will help inform the clinical decisions of physicians who treat pregnant women. They advise that while a discussion of risks and benefits is important but the decision to stop or maintain treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors caution that, while stopping the medication is a possibility to consider, it is not advised because of the high incidence of depression and other mental disorders among women who are pregnant or have recently given birth. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience difficulties adapting to life without them following the baby's arrival.

Nursing

The responsibilities of a new mom can be overwhelming. Women who suffer 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 a new routine. This is why many women choose to continue taking their ADHD medications throughout the course of pregnancy.

The majority of stimulant drugs are absorbed through breast milk in small amounts, therefore the risk to breastfeeding infant is minimal. However, the frequency of exposure to medications by the infant can differ based on the dosage, frequency it is administered and at what time the medication is administered. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not well understood.

Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must weigh the benefits of keeping her medication with the potential dangers to the fetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal period.

A growing number of studies have shown that most women can safely continue to take their ADHD medication while they are pregnant and nursing. This has led to more and more patients are choosing to do so and, in consultation with their physician, they have found that the benefits of keeping their current medication exceed any risk.

It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also learn about treatment options and strengthen coping mechanisms. This should be a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include the discussion of a treatment plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and the need for adjustments to the medication regimen.