ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There is adhd uk medication of information about how long-term exposure to these drugs can affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological conditions like impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the benefits of using them against the risks to the fetus. Doctors don't have the data needed to give clear guidelines, but they can provide information about the risks and benefits to 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 have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a massive sample-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure correct classification of the cases and to reduce the chance of bias.
The study of the researchers was not without its limitations. Most important, they were not able to differentiate the effects of the medication from the effects of the disorder at hand. That limitation makes it difficult to know whether the small associations observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. In addition the researchers did not examine the long-term outcomes of offspring.
The study found that infants whose mother took ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages could be offset by the greater benefits to both baby and mother of continued treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve their coping abilities that can lessen the impact of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is one that doctors are having to confront. These decisions are usually made without clear and authoritative evidence. Instead, doctors have to consider their own expertise and experience, as well as the experiences of other physicians and the research that has been conducted on the subject.
Particularly, the subject of possible risks to the baby can be tricky. Many of the studies on this subject are based on observational evidence rather than controlled research and their findings are often contradictory. Most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these limitations by looking at data from both live and deceased births.
Conclusion: While some studies have found a positive correlation between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies have shown an unintended, or slight negative impact. In the end an accurate risk-benefit analysis must be conducted in every situation.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In fact, in an article published in the 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 those suffering from the disorder. In addition, a decrease in medication can affect the ability to perform job-related tasks and drive safely, which are important aspects of a normal life for many people with ADHD.
She recommends women who are unsure about whether to continue or discontinue medication due to their pregnancy, consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of continuing the current treatment plan. It will also help a woman feel more confident in her decision. click through the next website page is important to note that some drugs can be absorbed through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be passed on to the baby.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the possible effects of the drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. With two massive data sets researchers were able look at more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.
The researchers behind the study found no link between early use of medication and other congenital anomalies, like facial clefting, or club foot. The results are in line with previous studies that have shown a small, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before pregnancy. The risk grew in the latter half of pregnancy, when a lot of women are forced to stop taking their medication.
Women who used ADHD medication in the first trimester of their pregnancy were also more likely to experience caesarean section, low Apgar score after delivery and a baby who required breathing assistance at birth. The researchers of the study were unable to eliminate selection bias because they limited their study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope their research will help doctors when they meet pregnant women. They recommend that, while the discussion of the risks and benefits is crucial however, the decision to stop or continue treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also advise that while discontinuing the medications is an option, it isn't an option to consider due to the high prevalence of depression and other mental health issues among women who are pregnant or recently postpartum. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience a difficult time getting used to life without them after the birth of their baby.
Nursing
It can be a stressful experience to become a mother. Women who suffer from ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed by breast milk in very small amounts, so the risk to the infant who is breastfeeding is low. The amount of exposure to medications will vary based on the dosage the medication is administered, its frequency and the time of the day. In addition, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The effect on a newborn's health is not completely understood.
Due to the absence of research, some doctors may recommend stopping stimulant drugs during the pregnancy of a woman. This is a difficult decision for the patient, who must weigh the benefits of keeping her medication with the potential risks to the embryo. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.
Numerous studies have demonstrated that women can continue taking their ADHD medication in a safe manner while breastfeeding and during pregnancy. This has led to more and more patients opt to do this and in consultation with their doctor they have found that the benefits of continuing their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to breastfeed 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 for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and strengthen the coping mechanisms. This should include a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include discussion of a management plan for both the mother as well as the child, and monitoring for signs of deterioration, and the need for adjustments to the medication regimen.