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 regarding how exposure over time may affect a foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don’t develop neurological disorders like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking get adhd medication online medication need to evaluate the benefits of using it versus the dangers for the fetus. The doctors don’t have the information to give clear advice, but can provide information on risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to confirm that the classification was accurate and to reduce any bias.
The study of the researchers was not without limitations. Researchers were unable to, in the first place, to separate the effects of the medication from the disorder. This makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medications or if they were caused by co-morbidities. Additionally the researchers did not look at the long-term effects of offspring on their parents.
The study revealed that infants whose mother 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 did not take any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an elevated chance 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 used during pregnancy.
Researchers suggest that the small risks associated with the use adhd medication making it worse medications during early pregnancies may be offset by the greater benefits for baby and mother of continued treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, where possible, help them develop strategies to improve coping skills that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the issue of whether or not to stop treatment during pregnancy is one that more and more doctors have to face. These decisions are frequently made without clear and reliable evidence. Instead, doctors have to take into account their own experience, the experience of other doctors, and the research that has been conducted on the subject.
Particularly, the subject of potential risks for the baby can be a challenge. The research on this issue is based on observations instead of controlled studies and a lot of the results are conflicting. In addition, most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these issues by looking at data from both live and deceased births.
The conclusion is that while some studies have found a positive association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative effect. In all cases an in-depth analysis of the risks and benefits must be performed.
For a lot of women with ADHD, the decision to discontinue medication is difficult, if not impossible. In a recent article in 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. Furthermore, a loss of medication may affect the ability to perform work-related tasks and safely drive that are crucial aspects of daily life for a lot of people with ADHD.
She suggests that women who are not sure whether to take the medication or stop it due to their pregnancy, educate their family members, colleagues, and acquaintances about the condition, the impact on daily functioning and the advantages of staying on the current treatment plan. It will also help a woman feel more confident in her decision. It is important to remember 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 must be aware that traces of the drug could be transferred to the child.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases as does the concern about the possible effects of the drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study didn’t find any association between early medication usage and other congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who began taking ADHD medication prior to the time of the time of pregnancy. This risk increased in the latter half of pregnancy, as many women begin to discontinue their medication.
Women who used ADHD medications in the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who needed breathing assistance during birth. The researchers of the study could not remove bias in selection since they limited their study to women without other medical conditions that could have contributed to the findings.
The researchers hope their research will serve to inform the clinical decisions of doctors who treat pregnant women. The researchers recommend that, while discussing risks and benefits are important, the choice on whether to continue or stop taking medication should be based on the severity of each woman’s ADHD symptoms and her requirements.
The authors also warn that, while stopping the medication is an option, it is not an option that is recommended due to the high incidence of depression and other mental health issues in women who are pregnant or recently postpartum. Additionally, the research suggests that women who choose to stop taking their medications are more likely to have difficulties adapting to life without them after the baby’s arrival.
Nursing
The responsibilities that come with being a new mother can adhd medication help with memory be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments, making preparations for the arrival of a baby and adjusting to new household routines may face a lot of challenges. Many women choose to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The amount of exposure to medications will differ based on dosage and frequency of administration as well as time of day. Additionally, individual medications enter the baby’s system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn isn’t fully 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 mother, who must weigh the benefits of continuing her medication against the risk to the foetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. In response, a growing number of patients are choosing to do so. They have concluded, in consultation with their physicians, that the benefits of continuing their current medication far outweigh any potential risks.
It is crucial for women suffering from adhd medication guide who are thinking of breastfeeding to seek a specialist psychiatrist’s guidance prior to becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also learn about treatment options and build strategies for coping. This should involve a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.