The Ugly Facts About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how long-term exposure may 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 that more high quality studies are required.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the foetus. Doctors don't have enough data to provide clear recommendations but they can provide information on the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case control study to compare the incidence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure an accurate case classification and to limit the possibility of bias.
However, the researchers' study was not without its flaws. Researchers were unable to, in the first place to distinguish the effects of the medication from the disorder. This makes it difficult to determine whether the small differences observed in the groups that were exposed result from medication use or confounding by comorbidities. Additionally the researchers did not examine the long-term effects of offspring on their parents.
The study revealed that babies whose mothers took ADHD medication during pregnancy were at a slightly higher chance of being admitted 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. The reason for this was central nervous system disorders, and the increased risk for admission did not appear to be influenced by the stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having to have an emergency caesarean section or having the baby was not scoring well 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.
The researchers suggest that the risk of a small amount 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 speak with their patients about this issue and, if possible, help them improve coping skills which may reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is one that doctors are having to face. These decisions are frequently made without clear and reliable evidence. Instead, physicians must consider their own expertise, the experience of other physicians and the research on the subject.
In particular, the issue of potential risks to the infant can be difficult. Many of the studies on this issue are based on observational evidence rather than controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing information on deceased and live births.
The conclusion The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no connection, and most studies have a neutral or slight negative effect. Therefore, a careful risk/benefit assessment must be done in each case.
It can be challenging, if not impossible for women suffering from ADHD to stop taking their medication. In a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping adhd medication uk for adults medications during pregnancy can increase 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 essential aspects of everyday life for those suffering from ADHD.
She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy, educate their family members, coworkers and their friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment regimen. It can also help a woman feel more confident in her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could be passed on to her infant.
Birth Defects Risk
As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (Adhd medication Prices uk), increases, so does concern about the potential adverse effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Using two massive data sets researchers were able look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester adhd focus medication medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defect.
The authors of the study found no connection between the use of early medications and other congenital anomalies, such as facial clefting or club foot. The results are in the same vein as previous studies that have shown 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. This risk increased during the latter part of pregnancy, when a lot of women are forced to stop taking their ADHD medication.
Women who used ADHD medications in the first trimester of their pregnancy were also more likely to undergo a caesarean section, a low Apgar score following delivery, and a baby who needed help breathing at birth. However, the authors of the study were not able to eliminate selection bias by limiting the study to women who didn't have any other medical issues that could be a contributing factor to these findings.
Researchers hope that their research will help doctors when they meet pregnant women. The researchers suggest that while discussing risks and benefits are crucial, the decision about whether to continue or stop taking medication should be based on the severity of each woman's ADHD symptoms and her needs.
The authors also warn that while discontinuing the medications is an option, it isn't an option to consider due to the high incidence of depression and other mental health issues for women who are expecting or who are recently post-partum. Furthermore, research suggests that women who choose to stop taking their medication are more likely to experience a difficult time adjusting to life without them following the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD who have to manage their symptoms while attending physician appointments as well as making preparations for the arrival of their child and getting adhd medication uk used to new routines at home may face a lot of challenges. Many women choose to continue taking their adhd medication ritalin medication during pregnancy.
The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk at a low level. The rate of medication exposure will differ based on dosage and frequency of administration as well as time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn infant is not yet fully understood.
Because of the lack of research, some doctors might be tempted to stop taking stimulant medications during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the advantages of her medication against the risk to the fetus. In the meantime, until more information is available, doctors may ask pregnant patients whether they have an history of ADHD or if they intend to take medication in the perinatal period.
Numerous studies have proven that women can continue taking their ADHD medication in a safe manner during pregnancy and while breast-feeding. In the end, an increasing number of patients choose to do so and after consulting with their doctor, they have found that the benefits of maintaining their current medication far outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, and monitoring for indicators of deterioration, and, if necessary modifications to the medication regimen.