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

ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medications during pregnancy and nursing is challenging for women with the condition. There aren't many studies on how exposure to ADHD for a long time could affect the fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological conditions like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.

Risk/Benefit Analysis

Pregnant women who take ADHD medications need to balance the advantages of taking them against the potential risks to the foetus. Physicians don't have the data needed to provide clear recommendations but they can provide information about risks and benefits that assist pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face an higher risk of fetal cardiac malformations or major structural birth defects. The researchers used a large population-based study of case-control to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was accurate and to eliminate any bias.

The study conducted by the researchers was not without limitations. The most important issue was that they were unable to distinguish the effects of the medication from those of the disorder that is underlying. This makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of medication or if they were caused by the presence of comorbidities. In addition, the researchers did not study the long-term outcomes of offspring.

The study found that babies whose mothers had taken ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy or had stopped taking their medication before or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medications were used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this and as much as possible, assist them improve coping skills which could reduce the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

More and more doctors are confronted with the dilemma Types of adhd medication whether to maintain treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are taken in the absence of solid and reliable evidence regardless, so doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what the research suggests on the subject as well as their own best judgment for each patient.

The issue of possible risks to infants is extremely difficult. The research on this issue is based on observation rather than controlled studies and many of the findings are in conflict. Furthermore, most studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by analyzing 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 slight negative effect. In all cases, a careful study of the benefits and risks is required.

It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In fact, in a recent article in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for patients with ADHD. Additionally, the loss of medication can interfere with the ability to do jobs and drive safely which are essential aspects of daily life for many people suffering from ADHD.

She suggests women who are unsure about whether or not to discontinue medication due to their pregnancy consider informing family members, friends and colleagues on the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. It can also help women feel more confident in her decision. It is important to note that some medications can pass through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the medication 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) grows, so do concerns over the impact that these medications could have on 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 over 4.3 million pregnant women and determine whether stimulant medications caused birth defects. While the overall risk remains low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects, such as ventriculo-septal defect (VSD).

The researchers behind the study found no link between early medication use and congenital abnormalities such as facial clefting or club foot. The results are in agreement with previous studies which showed a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to pregnancy. The risk grew in the later part of pregnancy, when a lot of women begin to discontinue their ADHD medication.

Women who were taking ADHD medication during the first trimester were more likely to need a caesarean and also have an insufficient Apgar after birth and had a baby that required help breathing after birth. The researchers of the study were not able to eliminate bias due to selection because they restricted the study to women with no other medical conditions that could have contributed to the findings.

Researchers hope their research will inform physicians when they meet pregnant women. The researchers suggest that while discussing the risks and benefits are important, the choice on whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her needs.

The authors also warn that while discontinuing the medications is an option, it is not a recommended practice because of the high prevalence of depression and other mental health problems in women who are pregnant or who are recently post-partum. Additionally, research suggests that women who stop taking their medication will have a tough time adjusting to a life without them once the baby is born.

Nursing

The responsibilities that come with being a new mother can be overwhelming. Women suffering from ADHD may face a lot of challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to new adhd medication routines. 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 rate of medication exposure will differ based on dosage the medication is administered, its frequency and the time of the day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn isn't fully known.

Because of the lack of evidence, some doctors might be tempted to stop taking stimulant medications during the pregnancy of a woman. This is a difficult decision for the woman, who must weigh the benefits of taking her medication as well as the risk to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal time.

A increasing number of studies have revealed that women can continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are choosing to do this. They have concluded through consultation with their doctors that the benefits of continuing their current medication far outweigh any possible risks.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non prescription adhd medication for adults-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and reinforce the coping mechanisms. This should involve an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. The pregnancy counselling should consist of the discussion of a plan for management for both the mother as well as the child, monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.