The 10 Scariest Things About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how long-term exposure may affect a pregnant fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the benefits of using them against the risks to the foetus. Physicians don't have the information needed to make unequivocal recommendations but they can provide information on benefits and risks that can aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who were taking adhd medication guanfacine (Read the Full Document) medication in early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to examine the prevalence of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate classification of the cases and to reduce the chance of bias.
The research conducted by the researchers had some limitations. Researchers were unable, in the first place to distinguish the effects caused by the medication from the disorder. This 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 slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take 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 the stimulant medications were used during pregnancy.
Women who took stimulant buy adhd medication uk medication during pregnancy were also at an elevated chance of having a caesarean delivery or having a child with an low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medications in early pregnancies can be offset by greater benefits to both baby and mother of continued treatment for the woman's condition. Physicians should talk to their patients about this and try to help them improve coping skills which could reduce the impact of her disorder in her daily life and relationships.
Interactions with Medication
As more women than ever are diagnosed with ADHD and treated with medication, the issue of whether to continue or stop treatment during pregnancy is a question that doctors are having to have to face. These decisions are usually made without clear and authoritative evidence. Instead, doctors have to take into account their own experience in conjunction with the experiences of other physicians and the research on the topic.
The issue of risk for infants can be particularly tricky. The research that has been conducted on this topic is based on observation rather than controlled studies and the results are conflicting. Furthermore, most studies restrict their analysis to live births, which may undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.
Conclusion Some studies have revealed an association between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show that there is a neutral, or somewhat negative, impact. Therefore an accurate risk-benefit analysis must be done in each instance.
It isn't easy, but not impossible for women suffering from ADHD to stop taking their medication. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of isolation. A decrease in medication could also impact the ability to drive safely and perform work-related tasks, which are essential aspects of daily 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 family members, coworkers and friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment plan. Educating them can also make the woman feel more comfortable in her struggle with her decision. It is important to note that some drugs can pass through the placenta, so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug could be transferred to the child.
Birth Defects and Risk of
As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as does the concern about the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. With 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. Researchers found that while 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 didn't find any association between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are in line with previous studies revealing an increase, but not significant, in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of pregnancy. The risk grew during the latter part of pregnancy, as many women are forced to stop taking their adhd focus medication medications.
Women who took ADHD medication 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 researchers of the study were not able to eliminate bias due to selection by limiting the study to women who didn't have any other medical issues that could have contributed to these findings.
The researchers hope that their research will help inform the clinical decisions of physicians who treat pregnant women. The researchers advise that while discussing risks and benefits are important, the decision on whether to continue or stop medication should be made according to the severity of each woman's ADHD symptoms and her requirements.
The authors warn that, although stopping the medication is an option to consider, it is not advised due to the high rate depression and other mental problems among women who are pregnant or have recently given birth. Additionally, the research suggests that women who decide to stop taking their medication are more likely to have a difficult time adjusting to life without them following the baby's arrival.
Nursing
It can be a challenge to become a mom. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments and preparing for the arrival of a child and getting used to new routines at home are often faced with a number of difficulties. As such, many women decide to continue taking their ADHD medications throughout pregnancy.
The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk at low levels. However, the rate of exposure to medications by the infant can differ based on the dosage, frequency it is administered, and the time of day the medication is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not fully understood.
Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the lack of research. It is a difficult decision for the woman, who must weigh the advantages of her medication against the risks to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their history of ADHD and if they plan or are taking to take medication during the perinatal time.
A increasing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are choosing to do this. They have found through consultation with their doctors, that the benefits of continuing their current medication outweigh any risk.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior to 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 pregnant people with ADHD recognize their symptoms and underlying disorder, learn about available treatments and to reinforce existing coping strategies. This should include a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counselling should include the discussion of a treatment 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.