10 Quick Tips About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these drugs may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Pregnant women who take different adhd medications medications must weigh the advantages of taking them against the potential risks to the fetus. Physicians don't have the information needed to make unequivocal recommendations but they can provide information on the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large population-based case control study to examine the prevalence of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to minimize the chance of bias.
However, the researchers' study was not without its flaws. The researchers were not able, in the first place to distinguish the effects caused by the medication from the disorder. This makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to the use of medication or affected by co-morbidities. Researchers also did not examine the long-term effects for the offspring.
The study did find that infants whose mothers had taken private adhd medication cost medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system-related disorders and the increased risk of admission did not appear to be influenced by which stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risks posed by the use of adhd medication without diagnosis uk medication during pregnancies in the early stages can be offset by greater benefits for mother and baby of continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies for improving their coping skills that can lessen the impact 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 issue of whether or not to end treatment during pregnancy is a question that more and more physicians face. Most of the time, these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh what they know from their own experiences, those of other doctors, and what the research suggests on the subject, along with their best judgment for each patient.
The issue of potential risks to the infant can be particularly tricky. The research that has been conducted on this topic is based on observations rather than controlled studies and the results are conflicting. The majority of studies focus on live-births, which could underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both data on live and deceased births.
Conclusion A few studies have shown an association between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies show that there is a neutral, or slightly negative, impact. As a result, a careful risk/benefit analysis must be conducted in every case.
It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In an article recently 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 isolation, and family conflict for these patients. The loss of medication can also impact the ability to safely drive and complete work-related tasks, which are crucial aspects of normal life for those suffering from ADHD.
She suggests that women who are unsure whether to continue taking medication or stop due to pregnancy educate family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the benefits of keeping the current treatment plan. It can also aid in ensuring that the woman feels supported as she struggles with her decision. Some medications can pass through the placenta. If the patient decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be passed on to her infant.
Birth Defects Risk
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the drugs could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Researchers used two massive data sets to examine over 4.3 million pregnancy and determine if stimulant medication use caused birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect.
The authors of the study found no connection between early medication use and congenital abnormalities like facial clefting, or club foot. The results are consistent with previous studies that have shown an increase, but not significant, in the risk of heart malformations among women who began taking concerta adhd medication medications prior to the time of the time of pregnancy. This risk increased in the latter half of pregnancy, as many women decide to stop taking their ADHD medication.
Women who used common Adhd Medications uk medications in the first trimester of their pregnancies were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby that required help breathing at birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical conditions that could have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of physicians who encounter pregnant women. They recommend that, while the discussion of the benefits and risks is important however, the decision to stop or continue treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors caution that, while stopping the medication is a possibility to look into, it is not recommended due to the high prevalence of depression and other mental disorders in women who are expecting or have recently given birth. Additionally, the research suggests that women who decide to stop taking their medication are more likely to experience difficulties adapting to life without them following the birth of their baby.
Nursing
The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending doctor appointments as well as preparing for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. As such, many women elect to continue taking their ADHD medication throughout the pregnancy.
The risk to a breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the frequency of exposure to medications used to treat adhd by the newborn may differ based on dosage, how often it is taken and the time of the day it is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn is not yet fully understood.
Because of the lack of research, some physicians may recommend stopping stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must balance the benefits of keeping her medication against the possible risks to the embryo. As long as more information is available, GPs may inquire about pregnant patients if they have any background of ADHD or if they intend to take medication during the perinatal phase.
Many studies have shown that women can continue to take their ADHD medication without risk during pregnancy and while breast-feeding. In response, a rising number of patients are choosing to do this. They have found through consultation with their physicians, that the benefits of continuing their current medication outweigh any possible risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help women with ADHD recognize their symptoms and the root cause, learn about available treatment options and strengthen existing strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, monitoring of signs of deterioration and, if needed adjustments to the medication regimen.