20 Trailblazers Leading The Way In ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how long-term exposure to these medications may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have enough data to make unambiguous recommendations, but can provide information on the risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy did not have a greater risk of fetal malformations, or structural birth defects. The researchers used a large, population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure accurate classification of the cases and to reduce the possibility of bias.
However, the researchers' study had its limitations. Most important, they were unable to separate the effects of the medication from those of the disorder at hand. This limitation makes it difficult to know whether the limited associations observed in the exposed groups result from medication use or comorbidities that cause confusion. The researchers did not study long-term outcomes for offspring.
The study revealed that babies whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medications used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean birth or having a child with a low Apgar score (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy.
Researchers suggest that the minor risks posed by the use of concerta adhd medication medications in early pregnancies can be offset by greater benefits to both mother and baby of continuing treatment for the woman's condition. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve their coping abilities that can lessen the effects of her disorder on her daily functioning and relationships.
Medication Interactions
Many doctors are faced with the decision of whether to keep treatment or stop as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must consider their own expertise, the experience of other doctors and the research that has been conducted on the subject.
Particularly, the issue of potential risks for the infant can be difficult. Many of the studies on this issue are based on observations rather than controlled research and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that can lead to abortions or terminations of pregnancy. The study discussed in the journal club addresses these issues by analyzing data on live and deceased births.
The conclusion: While some studies have found an association between ADHD medications and the risk of certain birth defects, others have found no such relationship and the majority of studies demonstrate a neutral or slight negative effect. In every case it is imperative to conduct a thorough evaluation of the risks and benefits must be performed.
It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping adult adhd medication uk medication during pregnancy can increase depression, feelings of loneliness and family conflict for these patients. Furthermore, a loss of medication can affect the ability to complete job-related tasks and drive safely which are essential aspects of a normal life for many people with ADHD.
She suggests that women who aren't sure whether to take the medication or discontinue it due to pregnancy should educate family members, coworkers, and their friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also help women feel confident about her decision. It is important to note that certain medications are able to pass through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be passed on to the baby.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns over the counter adhd medication uk medication for adhd (more..) the impact that these drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine if stimulant medication use increased the risk of birth defects. Researchers discovered that although the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.
The researchers of the study found no link between early use of medication and other congenital anomalies, such as facial clefting or club foot. The results are consistent with previous studies showing an increase, but not significant, in the risk of developing cardiac malformations in women who started taking adhd no medication medications prior to the time of pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who used ADHD medication in the first trimester of their pregnancies were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance at birth. The authors of the study were unable to remove bias in selection since they limited their study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope that their research will provide doctors with information when they see pregnant women. The researchers recommend that, while discussing benefits and risks are important, the choice regarding whether or not to stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors also advise that, while stopping the medication is an option, it is not a recommended practice because of the high rate of depression and other mental health problems in women who are pregnant or recently postpartum. Additionally, the research suggests that women who decide to stop their medications are more likely to experience a difficult time getting used to life without them following the baby's arrival.
Nursing
The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments and making preparations for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. Many women opt to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small amounts, therefore the risk to nursing infant is very low. However, the rate of exposure to medications by the newborn can vary depending on dosage, frequency it is administered and the time of day it is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn is not yet fully understood.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the lack of research. This is a complicated decision for the patient, who must balance the benefit of continuing her medication against the possible risks to the fetus. In the meantime, until more information is available, doctors can inquire about pregnant patients if they have a history of ADHD or if they intend to take medication in the perinatal stage.
A growing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are opting to continue their medication. They have found through consultation with their physicians that the benefits of keeping their current medication outweigh potential risks.
Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also be informed about treatment options and reinforce the coping mechanisms. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regime.