How To Beat Your Boss 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 aren't many studies on how exposure to ADHD for a long time could affect a pregnant fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to consider the benefits of taking it against the possible risks for the foetus. Doctors don't have the data needed to make unequivocal recommendations however they can provide information regarding risks and benefits that aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at higher risk of fetal malformations or structural birth defects. The researchers used a large population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure accurate classification of the cases and to reduce the possibility of bias.
However, the study was not without its flaws. Most important, they were unable to distinguish the effects of the medication from those of the disorder that is underlying. This makes it difficult for researchers to determine if the small differences observed between the exposed groups were due to the use of medications, or if they were caused by the presence of comorbidities. The researchers did not examine long-term outcomes for offspring.
The study showed that infants whose mother took ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) in comparison 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 influenced by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a baby 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 liquid adhd medication medications during the early stages of pregnancy could be offset by the higher benefit to both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, help them develop strategies for improving their coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
Many doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with liquid adhd medication. Often, these decisions are made without solid and reliable evidence in either case, which means that doctors must weigh what they know about their experiences, the experiences of other doctors, and what research suggests on the subject, along with their best medication for inattentive adhd judgment for each individual patient.
The issue of risk to the infant can be difficult to determine. 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 can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing both data on live and deceased births.
The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies show a neutral or even slightly negative impact. Therefore, a careful risk/benefit assessment must be done in each instance.
For a lot of women with ADHD and ADD, the decision to stop taking 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 weekends adults ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for those suffering from the disorder. Additionally, the loss of medication may affect the ability to do jobs and drive safely, which are important aspects of daily life for a lot of people with safest adhd medication for adults medication titration (ezproxy.cityu.edu.Hk).
She suggests that women who are not sure whether to take the medication or stop due to pregnancy should educate family members, coworkers, and their friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment. Educating them can also help the woman feel supported in her struggle with her decision. It is important to note that certain drugs can pass through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be transferred to the infant.
Risk of Birth Defects
As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Using two massive data sets researchers were able to look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study did not discover any connection between early use of medication and congenital anomalies like facial deformities, or club feet. The results are consistent with previous studies revealing a small but significant increase in the risk of cardiac malformations in women who started taking ADHD medications before the birth of their child. This risk increased during the latter stages of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely need a caesarean and also have an insufficient Apgar after birth and have a baby that needed help breathing after birth. However, the authors of the study were not able to eliminate selection bias by limiting the study to women who didn't have other medical issues that could have contributed to these findings.
The researchers hope their research will aid in the clinical decisions of doctors who treat pregnant women. The researchers suggest that, while discussing benefits and risks are important, the choice regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and her requirements.
The authors also warn that while discontinuing the medications is an option, it isn't an option to consider due to the high rate of depression and other mental health problems for women who are expecting or postpartum. Research has also shown that women who stop taking their medication will have a difficult transitioning to life without them after the baby is born.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD can face severe challenges when they have to manage their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at a low level. However, the amount of medication exposure to the newborn can vary depending on the dosage, frequency it is taken and the time of day it is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The impact on a newborn's health is not fully understood.
Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the absence of research. It is a difficult decision for the woman, who must weigh the benefits of her medication against the potential risks to the fetus. As long as there is no more information, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal period.
A growing number of studies have proven that the majority of women are able to safely continue their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are opting to do so. They have found after consulting with their doctors, that the benefits of continuing their current medication outweigh possible risks.
Women with ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and the root cause and learn about treatments and to reinforce existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration, and, if needed modifications to the medication regimen.