• 목록
• 답변
• 글쓰기
• 게시판 리스트 옵션
  • 수정
  • 삭제

ADHD Medication During Pregnancy and Breastfeeding

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

A recent study 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 higher-quality research.

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication need to weigh the benefits of taking it versus the dangers for the foetus. Physicians do not have the data needed to provide clear recommendations but they can provide information about the risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have a significantly increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a massive population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who prescribes adhd medication took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was correct and to minimize any bias.

However, the study was not without its flaws. In particular, they were unable to separate the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult to determine whether the small differences observed in the exposed groups are due to the use of medication or confounding by comorbidities. The researchers did not study long-term outcomes for the offspring.

The study did show that babies whose mothers had taken ADHD medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk for admission did not appear to be influenced by which stimulant medications were used during pregnancy.

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

The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefit to both the mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, when they are able, assist them in developing strategies to improve coping skills that may minimize the effects of her disorder on her daily functioning and relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and treated with medication, the question of whether to keep or end treatment during pregnancy is one that more and more doctors have to face. The majority of these decisions are made without any evidence that is clear and definitive regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests about the subject and their best judgment for each patient.

Particularly, the subject of potential risks for the baby can be tricky. The research that has been conducted on this topic is based on observation rather than controlled studies and a lot of the results are conflicting. Furthermore, most studies restrict their analysis to live births, which could underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings, by examining both data on live and deceased births.

The conclusion is that 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 demonstrate a neutral or slightly negative effect. Therefore an accurate risk-benefit analysis must be done in each situation.

For a lot of women with ADHD who suffer from ADHD, the decision to stop medication can be difficult, if not impossible. In a recent article published 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 being isolated. A loss of medication may affect the ability to safely drive and to perform work-related tasks which are vital aspects of normal life for people with ADHD.

She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy educate family members, coworkers, and acquaintances about the condition, its impact on daily functioning and the advantages of staying on the current treatment. In addition, educating them can make the woman feel more comfortable in her struggle with her decision. It is important to remember that certain medications can pass through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug could be transferred to the infant.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns over the impact that these drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Utilizing two huge data sets researchers were able examine more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects such as ventriculo-septal defect (VSD).

The authors of the study found no link between the use of early medications and other congenital anomalies, like facial clefting, or club foot. The results are in the same vein as previous studies that showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of pregnancy. The risk was higher in the latter half of pregnancy, when many women begin to discontinue their ADHD medication.

Women who took ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score following delivery, and a baby that required breathing assistance during birth. However the researchers of the study were not able to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could have contributed to the findings.

The researchers hope their research will serve to inform the clinical decisions of physicians who treat pregnant women. The researchers recommend that while discussing risks and benefits are important, the choice about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her requirements.

The authors also caution that, while stopping the medication is an alternative, it is not an option to consider due to the high prevalence of depression and other mental health issues among women who are pregnant or recently post-partum. Additionally, research suggests that women who stop taking their medications will have a difficult time adjusting to a life without them after the baby is born.

Nursing

The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, making preparations for the arrival of their child and adjusting to new household routines can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medications is absorbed through breast milk at a low level. However, the rate of exposure to medications by the infant can differ based on dosage, how often it is taken and the time of day it is administered. Additionally, individual 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 infant is not yet fully known.

Due to the absence of research, some doctors prescribing uk adhd medication medication - norris-kennedy.Federatedjournals.com - might be tempted to stop taking stimulant medication during a woman's pregnancy. This is a complicated decision for the patient, who must balance the benefit of continuing her medication against the possible risks to the foetus. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether they are taking or planning to take medication during the perinatal period.

A growing number of studies have proven 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 continuing their current medication far exceed any risk.

Women with 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 as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from adhd medication options be aware of the symptoms and underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both the mother as well as the child, as well as monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.