This Week s Top Stories About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data regarding how exposure over time may affect a fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental disorders like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against potential risks to the foetus. The doctors don't have the information to make unambiguous recommendations however they can provide information about risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, as well as those who can prescribe medication for adhd had not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was correct and to minimize any bias.
The study conducted by the researchers had some limitations. In particular, they were unable to distinguish the effects of the medication from the disorder at hand. This makes it difficult for researchers to determine whether the few associations observed between the groups exposed were due to medication use, or if they were confounded by comorbidities. Additionally the study did not study the long-term outcomes of offspring.
The study found that infants whose mother took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) in comparison to mothers who did not take any medication during pregnancy or had discontinued taking their best medication for adhd prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean delivery or having a baby with an low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medication during pregnancies in the early stages can be offset by more beneficial outcomes for both mother and baby from continuing treatment for the woman's condition. Doctors should discuss with their patients about this and try to help them develop coping strategies that could reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made without clear and authoritative evidence in either case, which means that doctors have to weigh their experience about their experiences, the experiences of other doctors, and what the research says on the topic as well as their own judgments for each individual patient.
In particular, the issue of potential risks to the baby can be tricky. Many of the studies on this topic are based on observational data rather than controlled research, and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing data on live and deceased births.
The conclusion: While some studies have shown an association between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies have a neutral or slightly negative impact. In every case, a careful analysis of the potential risks and benefits is required.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for these patients. Additionally, the loss of medication can interfere with the ability to do job-related tasks and drive safely that are crucial aspects of daily life for many people suffering from ADHD.
She suggests that women who aren't sure whether to take the medication or stop due to pregnancy should educate family members, coworkers, and their friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment. It will also help a woman feel more confident in her decision. It is important to note that some medications are able to pass through the placenta, so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug can be passed on to the baby.
Birth Defects Risk
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Researchers utilized two massive data sets to examine over 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The researchers behind the study found no association 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 showed a small, but significant increase in the number of cardiac malformations among women who started taking best adhd medication for adults uk medication before the birth of their child. The risk increased in the latter stages of pregnancy, when a lot of women decided to stop taking their medication.
Women who took common adhd medications uk (check out this site) medications in the first trimester of pregnancy were also more likely to experience caesarean section, low Apgar score following delivery, and a baby who needed breathing assistance at birth. The researchers of the study could not 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 their research will inform physicians when they meet pregnant women. They suggest that although discussing the risks and benefits is crucial, the decision to stop or keep medication should be based on each woman's needs and the severity of her ADHD symptoms.
The authors caution that, even though stopping the medication is an option to look into, it is not advised due to the high rate depression and other mental problems in women who are expecting or have recently given birth. Further, research shows that women who stop taking their medication will have a difficult transitioning to life without them once the baby is born.
Nursing
It can be overwhelming to become a mother. Women with ADHD who must work through their symptoms while attending doctor appointments, preparing for the arrival of a baby and adjusting to new household routines can experience severe challenges. As such, many women elect to continue taking their ADHD medications throughout pregnancy.
The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. However, the frequency of exposure to medication by the newborn can vary depending on the dosage, frequency it is administered and the time of day the medication is administered. Additionally, different medications are introduced into the baby's system via the gastrointestinal tract or through breast milk. The impact on the health of a newborn isn't fully understood.
Because of the lack of research, some physicians might be tempted to stop taking stimulant medication during the course of pregnancy. This is a complicated decision for the patient, who must balance the benefit of continuing her medication against the possible dangers to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal time.
A increasing number of studies have shown that women can continue taking their ADHD medication during pregnancy and breastfeeding. This has led to more and more patients choose to do so and after consulting with their doctor, they have discovered that the benefits of maintaining their current medication far outweigh any potential risks.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.