This Week s Top Stories About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from adhd medication ritalin have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological disorders such as hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of taking them against potential risks to the fetus. The doctors don't have the information to provide clear recommendations however they can provide information about risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not face a significantly increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large population-based study of case control to examine the prevalence of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was accurate and to minimize any bias.
However, the study had its limitations. Most important, they were unable to separate the effects of the medication from those of the disorder at hand. That limitation makes it difficult to know whether the small associations observed in the exposed groups are due to medication use or the confounding effect of comorbidities. The researchers also did not examine long-term outcomes for the offspring.
The study did reveal that babies whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had stopped their medications before or during pregnancy. This increase was due to central nervous system-related disorders and the increased risk of admission was not found to be influenced by which stimulant medications were used during pregnancy.
Women who used stimulant inattentive adhd medication uk medication during pregnancy also had an increased chance of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases did appear to be independent of 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 speak with their patients about this issue and as much as possible, assist them improve coping skills which may reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether to continue or stop treatment during pregnancy is a question that more and more doctors confront. These decisions are frequently made without clear and authoritative evidence. Instead, physicians must consider their own expertise, the experience of other doctors and the research on the subject.
The issue of potential risks for infants can be extremely difficult. The research on this issue is based on observations rather than controlled studies, and many of the findings are conflicting. In addition, most studies limit their analysis to live births, which can underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by looking at data from both live and deceased births.
The conclusion is that while some studies have shown a positive association between buy adhd Medication Online uk medications and the risk of certain birth defects, others have found no connection, and most studies demonstrate a neutral or slight negative effect. Therefore, a careful risk/benefit assessment must be done in each case.
For many women with ADHD who suffer from ADHD, the decision to stop taking medication is difficult, if not impossible. 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 isolation, and family conflict for those suffering from the disorder. The loss of medication can also affect the ability to safely drive and perform work-related tasks, which are crucial aspects of everyday life for those suffering from ADHD.
She recommends women who are unsure about whether or not to stop medication in light of their pregnancy consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily life, and the benefits of keeping the current treatment plan. Educating them can also aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can be passed through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication could be transferred to the infant.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases as does the concern about the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Using two massive data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Although the risk overall 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 authors of the study did not discover any link between the use of early medications and other congenital anomalies, such as facial deformities or club feet. The results are in line with previous studies that showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of pregnancy. The risk increased in the latter half of pregnancy when many women began to stop taking their medication.
Women who used ADHD medication in the first trimester of pregnancy were also more likely to have a caesarean section, a low Apgar score after delivery and a baby who needed help breathing at birth. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could be a contributing factor to these findings.
The researchers hope that their research will help inform the clinical decisions of doctors who encounter pregnant women. They suggest that although discussing risks and benefits is important however, the decision to stop or continue medication should be based on the woman's needs and the severity of her ADHD symptoms.
The authors also caution that while discontinuing the medications is an option, it is not a recommended practice because of the high incidence of depression and other mental health issues among women who are pregnant or postpartum. Additionally, research suggests that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.
Nursing
It can be a stressful experience becoming a mother. Women with ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to new routines. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy.
The majority of stimulant medicines pass through breast milk in low quantities, so the risk to infant who is breastfeeding is low. The amount of exposure to medications will differ based on dosage and frequency of administration as well as the time of day. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The impact on the health of a newborn is not completely understood.
Because of the lack of research, some physicians may be inclined to discontinue stimulant drugs during the course of pregnancy. This is a difficult decision for the patient, who must balance the benefit of continuing her medication against the possible dangers to the foetus. Until more information becomes available, GPs may inquire about pregnant patients whether they have a background of ADHD or if they plan to take medication in the perinatal phase.
A increasing number of studies have shown that the majority of women are able to safely continue their ADHD medication during pregnancy and breastfeeding. In response, an increasing number of patients are choosing to do this. They have discovered through consultation with their physicians, that the benefits of retaining their current medication outweigh risk.
It is essential for women with ADHD who are considering breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and reinforce strategies for coping. This should involve a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.