What The Heck What Exactly Is ADHD Medication Pregnancy
adhd anxiety medication Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications could affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD best medication for ocd And adhd during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high-quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of taking them against the potential risks to the fetus. Physicians do not have the data needed to make unequivocal recommendations but they can provide information about risks and benefits that assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy and those who can prescribe adhd medication had not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was accurate and to minimize any bias.
However, the 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 limitation makes it difficult for researchers to determine if the small differences observed between the groups that were exposed to medication use, or if they were confounded by co-morbidities. Additionally the researchers did not look at long-term offspring outcomes.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a slightly greater 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. The reason for this was central nervous system disorders, and the increased risk for admission did not appear to be influenced by the stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean section or having a baby with low Apgar score (less than 7). These increases did appear to be unrelated to 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 greater benefit to both mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when they are able, assist them in developing strategies to improve their coping abilities that may minimize the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to maintain treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of clear and authoritative evidence in either case, which means that doctors have to weigh their experience, the experiences of other doctors, and what research suggests about the subject as well as their own judgments for each individual patient.
The issue of potential risks to the infant can be difficult to determine. Many of the studies on this topic are based on observational evidence instead of controlled research and their conclusions are often contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects that can lead to terminations or abortions of pregnancy. The study discussed in this journal club addresses these limitations by examining data on both live and deceased births.
Conclusion Some studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't established a link. The majority of studies show an unintended, or slightly negative, impact. In the end, a careful risk/benefit analysis must be conducted in every instance.
For many women with ADHD, the decision to discontinue medication is difficult, if not impossible. In fact, in an article recently published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness, and family conflict for patients with ADHD. Additionally, the loss of medication can affect the ability to perform work-related tasks and safely drive which are essential aspects of a normal life for many people with ADHD.
She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy, educate their family members, coworkers and their friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment plan. It will also help a woman feel confident about her decision. It is important to note that certain medications are able to be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the child.
Birth Defects Risk
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing, so does concern about the possible effects of the drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers utilized two massive datasets to analyze more than 4.3 million pregnant women and determine whether stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study could not find any association 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 revealing the presence of a small, but significant increase in the risk of cardiac malformations among women who started taking most effective adhd medication for adults medications before the birth of their child. The risk was higher in the later part of pregnancy, as many women are forced to stop taking their ADHD medications.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean delivery or have an insufficient Apgar after delivery, and have a baby who needed breathing assistance after birth. The authors of the study were not able to remove bias in selection since they limited the study to women without other medical conditions that might have contributed to the findings.
The researchers hope their research will help inform the clinical decisions of doctors who encounter pregnant women. The researchers advise that while discussing benefits and risks are important, the choice on whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors warn that, even though stopping the medication is a possibility to consider, it is not recommended because of the high incidence of depression and other mental problems for women who are pregnant or recently gave birth. Additionally, the research suggests that women who choose to stop their medications are more likely to experience a difficult time getting used to life without them following the birth of their baby.
Nursing
The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments and preparing for the arrival of a baby and getting used to new routines at home are often faced with a number of difficulties. As such, many women choose to continue taking their ADHD medications throughout pregnancy.
The risk to nursing infant is low because the majority of stimulant medications passes through breast milk at a low level. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and the time of the day. Additionally, different drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The impact on the health of a newborn isn't fully comprehended.
Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the advantages of her medication against the potential risks to the foetus. As long as more information is available, GPs may ask pregnant patients if they have an background of ADHD or if they are planning to take medication during the perinatal stage.
Numerous studies have demonstrated that women can a general practitioner prescribe adhd medication continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. This has led to an increasing number of patients are choosing to do so and in consultation with their doctor they have discovered that the benefits of maintaining their current medication outweigh any risks.
It is essential for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder and learn about treatment options and reinforce existing strategies for coping. This should be a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include the discussion of a plan for management for both the mother and child, monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.