The Three Greatest Moments In ADHD Medication Pregnancy History
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect a fetus.
A study recently 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 that further high-quality studies are 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. Physicians don't have the information needed to give clear guidelines however 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 took safest adhd medication medication in early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers used a large population-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was correct and to eliminate any bias.
However, the researchers' study was not without its flaws. Researchers were unable in the beginning to differentiate the effects caused by the medication from the disorder. That limitation makes it difficult to determine whether the small associations observed in the exposed groups are due to medication use or comorbidities that cause confusion. Additionally the study did not look at long-term offspring outcomes.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or taken off their medication 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 which stimulant medications prescribed for adhd were taken during pregnancy.
Women who used stimulant ADHD medication for inattentive adhd and anxiety during pregnancy were also at an increased chance of having a caesarean section or having a baby born with low Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both the mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this issue and, if possible, help them develop coping strategies that can lessen the impact of her disorder in her daily life and relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of any evidence that is clear and definitive either way, so physicians must weigh what they know, the experiences of other doctors, and what research suggests about the subject and their own judgments for each individual patient.
The issue of potential risks for infants can be difficult to determine. The research that has been conducted on this topic is based on observation rather than controlled studies and many of the findings are in conflict. In addition, most studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues by analyzing both the data from deceased and live births.
Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown that there is a neutral, or slight negative impact. As a result, a careful risk/benefit assessment must be conducted in every instance.
For many women with ADHD who suffer from ADHD, the decision to stop taking medication is difficult if not impossible. 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 loneliness, and family conflict for these patients. Additionally, the loss of medication can interfere with the ability to perform jobs and drive safely, which are important aspects of a normal life for a lot of people with ADHD.
She recommends women who are uncertain about whether to keep or stop taking medication because of their pregnancy consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and the advantages of continuing the current treatment plan. It will also help a woman feel more confident in her decision. It is important to remember that some medications can be absorbed 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 passed on to the baby.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about the effects that the drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers utilized two massive data sets to examine over the counter adhd medication for adults 4.3 million pregnancy and determine if the use of stimulant medications increased birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increased risk of specific heart defects, such as ventriculo-septal defect (VSD).
The researchers of the study found no connection between the use of early medications and other congenital abnormalities, like facial clefting, or club foot. The findings are in line with previous studies that have shown the presence of a small, but significant increase in the risk of cardiac malformations among women who started taking ADHD medications prior to pregnancy. The risk was higher in the later part of pregnancy, as many women begin to discontinue their medication.
Women who were taking ADHD medication in the first trimester were more likely need a caesarean, have an insufficient Apgar after delivery, and had a baby that required breathing assistance after birth. However, the authors of the study were unable to eliminate bias due to selection by restricting the study to women who did not have other medical issues that could have contributed to the findings.
Researchers hope that their study will provide doctors with information when they meet pregnant women. They recommend that, while the discussion of the benefits and risks is important but the decision to stop or keep treatment should be based on the woman's requirements and the severity of her ADHD symptoms.
The authors warn that, even though stopping the medication is a possibility to look into, it is not advised because of the high incidence of depression and other mental problems for women who are pregnant or who have recently given birth. Additionally, research suggests that women who stop taking their medication will have a tough time adjusting to a life without them after the baby is born.
Nursing
The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed through breast milk in low amounts, so the risk for breastfeeding infant is minimal. However, the rate of exposure to medications by the newborn may differ based on the dosage, frequency it is administered, and at what time the medication is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn infant is not yet fully known.
Some doctors may stop taking 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 advantages of taking her medication as well as the risk to the embryo. In the meantime, until more information is available, GPs may inquire about pregnant patients whether they have a history of ADHD or if they plan to take medication in the perinatal stage.
Many studies have shown that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. In response, an increasing number of patients are choosing to do so. They have concluded after consulting with their doctors, that the benefits of continuing their current medication outweigh any risk.
It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication for adhd and odd with their prescriber and discuss the advantages and disadvantages of continued treatment, including non prescription adhd medication-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and strengthen coping mechanisms. This should include a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, monitoring of indicators of deterioration, and, if needed adjustments to the medication regime.