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ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these medications could affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological conditions like hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the benefits of taking them against the potential risks to the fetus. Doctors don't have enough data to make unambiguous recommendations, but can provide information on the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who used adhd focus medication medications during early pregnancy did not have a significantly increased risk of fetal heart malformations or major birth defects that are structural. The researchers used a large population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate case classification and to minimize the possibility of bias.
However, the researchers' study had its limitations. Researchers were unable, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the few associations observed between the exposed groups were due to the use of medications or if they were caused by comorbidities. Researchers also did not examine the long-term effects for the offspring.
The study revealed that infants whose mother had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medications were used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a child with a low Apgar score (less than 7). These increases didn't seem to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medication during pregnancies in the early stages may be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman’s disorder. Physicians should talk to their patients about this and, if possible, help them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships.
Interactions with Medication
As more women than ever are being diagnosed with ADHD and treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is a question that more and more physicians confront. These decisions are usually made without clear and reliable evidence. Instead, doctors must consider their own expertise and experience, as well as the experiences of other doctors, and the research that has been conducted on the subject.
In particular, the issue of potential risks to the infant can be difficult. A lot of studies on this issue are based on observational data instead of controlled research and their conclusions are often contradictory. Most studies focus on live-births, which could underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study discussed in this journal club addresses these shortcomings by examining data on both live and deceased births.
The conclusion The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no connection and the majority of studies demonstrate a neutral or slightly negative effect. In the end, a careful risk/benefit analysis must be done in each situation.
It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping common adhd medications uk medications during pregnancy can lead to depression and feelings of isolation. The loss of medication can also affect the ability to drive safely and complete work-related tasks, which are essential aspects of normal life for people with ADHD.
She suggests women who are uncertain about whether or not to stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and the advantages of continuing the current treatment regimen. In addition, educating them can make the woman feel more comfortable when she is struggling with her decision. It is also worth noting that certain medications are able to be absorbed through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be passed on to the baby.
Risk of Birth Defects
As the use of intuitive Adhd Medication drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns over the impact that these drugs could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. With two massive data sets researchers were able examine 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 found no connection between the use of early medications and other congenital anomalies, such as facial clefting or club foot. The results are in line with previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the birth of their child. The risk was higher in the latter half of pregnancy, as many women decide to stop taking their ADHD medication.
Women who took adhd medication without prescribing medications in the first trimester of pregnancy were also more likely to undergo a caesarean section, a low Apgar score following delivery, and a baby that required breathing assistance at birth. However the researchers of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical issues that could have contributed to these findings.
Researchers hope their research will help doctors when they encounter pregnant women. They suggest that although discussing the risks and benefits is crucial but the decision to stop or continue medication should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also caution that while discontinuing the medications is an option, it isn't a recommended practice because of the high prevalence of depression and other mental health issues in women who are pregnant or post-partum. Further, the research suggests that women who decide to stop their medications 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 with liquid adhd medication uk who have to manage their symptoms while attending physician appointments as well as preparing for the arrival of a child and adapting to new routines in the home are often faced with a number of difficulties. This is why many women elect to continue taking their ADHD medications throughout pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk at a low level. However, the rate of medication exposure to the newborn can vary depending on dosage, how often it is administered, and the time of the day it is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn isn't yet fully known.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult decision for the patient, who must balance the benefits of continuing her medication against the potential dangers to the foetus. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time.
A growing number of studies have proven that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. As a result, many patients are choosing to do so and, in consultation with their doctor they have discovered that the benefits of continuing their current medication far outweigh any risks.
It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD be aware of their symptoms and the root cause, learn about available treatments and to reinforce existing strategies for managing. This should be a multidisciplinary process including obstetricians, GPs, 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 when necessary, making adjustments to the medication regimen.