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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these medications may affect the foetus.

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

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the benefits of using them against the risks to the foetus. Doctors don't have the information needed to make unequivocal recommendations but they can provide information regarding benefits and risks that can help pregnant women make informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy did not have a greater risk of fetal malformations, or structural birth defects. Researchers used a large population-based study of case control to assess the frequency of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure an accurate case classification and to minimize the possibility of bias.

However, the study was not without its flaws. The most important issue was that they were unable to separate the effects of the medication from those of the disorder at hand. That limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to medication use or confounding by comorbidities. In addition, the researchers did not examine the long-term effects of offspring on their parents.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having a caesarean section or a baby that scored low on the Apgar scale (less than 7). These risks did not 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 to both mother and child of continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them develop coping skills that can lessen the effects of her disorder on her daily functioning and her relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to continue or discontinue treatment during pregnancy is one that doctors are having to have to face. These decisions are often made without clear and reliable evidence. Instead, physicians must take into account their own experience, the experience of other doctors, and the research on the subject.

Particularly, the issue of potential risks for the baby can be tricky. Many studies on this subject are based on observational data rather than controlled research, and their findings are often contradictory. Furthermore, most popular adhd medication - use Technetbloggers, studies restrict their analysis to live births, which could underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing both the data from deceased and live births.

The conclusion: While certain studies have demonstrated an association between adhd medication for women medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies show a neutral or even slight negative effect. In every case an in-depth study of the benefits and risks must be performed.

For a lot of women with ADHD, the decision to stop taking medication is difficult if not impossible. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of isolation. The loss of medication can doctors prescribe adhd medication also affect the ability to drive safely and complete work-related tasks, which are vital aspects of everyday life for those suffering from ADHD.

She suggests that women who are not sure whether to continue taking medication or stop it due to their pregnancy, educate their family members, colleagues, and their friends about the condition, the impact on daily functioning and the benefits of keeping the current treatment plan. Educating them can also help the woman feel supported when she is struggling with her decision. Certain medications can be passed through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the drug could be transferred to the infant.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (natural adhd medication) increases the concern over the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Researchers used two massive data sets to examine over 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects.

The authors of the study did not find any association between early use of medication and other congenital anomalies, such as facial deformities or club feet. The results are in the same vein as previous studies that have shown an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of pregnancy. The risk grew in the latter half of pregnancy, when many women decide to stop taking their ADHD medication.

Women who took ADHD medication in the first trimester were more likely to require a caesarean birth or have a low Apgar after delivery, and have a baby that needed help breathing when they were born. The researchers of the study were not able to eliminate selection bias because they limited the study to women with no other medical conditions that could have contributed to the findings.

The researchers hope their study will aid in the clinical decisions of physicians who encounter pregnant women. The researchers recommend that, while discussing the risks and benefits are important, the decision regarding whether or not to stop taking medication should be in light of the severity of each woman's ADHD symptoms and her needs.

The authors also advise that even though stopping the medication is an option, it isn't a recommended practice because of the high prevalence of depression and other mental health issues for women who are expecting or recently postpartum. Further, the research suggests that women who decide to stop their medications are more likely to experience difficulties getting used to life without them after the baby's arrival.

Nursing

It can be a stressful experience to become a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments as well as getting ready for the arrival of their child and getting used to new routines at home are often faced with a number of difficulties. As such, many women decide to continue taking their ADHD medications throughout pregnancy.

The majority of stimulant drugs are absorbed through breast milk in very small amounts, therefore the risk to the nursing infant is very low. However, the rate of exposure to medications by the newborn may differ based on dosage, how often it is taken and the time of day it is administered. Additionally, different drugs enter the infant's system via the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn is not completely known.

Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the absence of research. It's a difficult choice for the woman who must weigh the benefits of taking her medication as well as the risk to the foetus. In the meantime, until more information is available, GPs may ask pregnant patients if they have a background of ADHD or if they are planning to take medication during the perinatal period.

Numerous studies have proven that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. In the end, an increasing number of patients choose to do so, and in consultation with their physician, they have found that the benefits of maintaining their current medication exceed any risk.

Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant women suffering from ADHD recognize their symptoms and underlying disorder and learn about treatment options and strengthen existing coping strategies. This should be an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration, and, if needed, adjustments to the medication regime.