ADHD Medication Pregnancy: The Good The Bad And The Ugly
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and breastfeeding is challenging for women with the condition. There are few data regarding how exposure over time may affect a pregnant fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the advantages of taking them against the potential risks to the fetus. Physicians do not have the necessary data to give clear guidelines, but they 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 took adhd medication names for adults medications during early pregnancy did not have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large population-based study of case control to assess the frequency of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure an accurate case classification and to limit the chance of bias.
However, the study was not without its flaws. Most important, they were unable to distinguish the effects of the medication from the disorder at hand. This makes it difficult to determine whether the small differences observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. Additionally the researchers did not examine the long-term outcomes of offspring.
The study did find 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 who were born without any medication or had cut back on their medications prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission did not appear to be influenced by which stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both the mother and child from continued treatment for the woman's disorder. Physicians should speak with their patients about this issue and try to help them develop coping skills that could reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to continue 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 from their own experiences, those of other doctors, and what research suggests about the subject and their own best judgment for each individual patient.
The issue of potential risks for infants Can Doctors Prescribe Adhd Medication (Anzforum.Com) be particularly tricky. The research on this subject is based on observations rather than controlled studies, and many of the findings are contradictory. The majority of studies focus on live births, which can underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both the data from deceased and live births.
Conclusion: While some studies have found an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies show an unintended, or slightly negative, effect. In every case an in-depth evaluation of the risks and benefits must be performed.
For many women with ADHD, the decision to stop medication is difficult if not impossible. In a recent article published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of being isolated. A loss of medication may also impact the ability to safely drive and to perform work-related tasks which are vital aspects of daily life for people with ADHD.
She recommends that women who are unsure about whether or not to stop medication in light of their pregnancy consider educating family members, friends and colleagues about the condition, its impact on daily life, and the advantages of staying on the current treatment plan. It will also help a woman feel more confident in her decision. It is also worth noting that certain medications can pass through the placenta, so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can a doctor prescribe adhd medication be passed on to the baby.
Risk of Birth Defects
As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing the concern over the possible effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects like ventriculo-septal defects (VSD).
The researchers behind the study found no link between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in agreement with previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication before pregnancy. This risk increased in the latter half of pregnancy, when many women are forced to stop taking their medication.
Women who took ADHD medications in the first trimester of their pregnancies were also more likely to have a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance at birth. The researchers of the study were not able to eliminate selection bias because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.
Researchers hope that their research will inform physicians when they see pregnant women. The researchers advise that, while discussing risks and benefits are crucial, the decision on whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her needs.
The authors warn that, while stopping the medication is an option to consider, it is not advised due to the high rate depression and other mental disorders among women who are pregnant or have recently given birth. Further, the research suggests that women who choose to stop taking their medications are more likely to have difficulties adjusting to life without them after the baby's arrival.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to a breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk in low amounts. The rate of exposure to medication can vary depending upon the dosage and frequency of administration as well as the time of the day. Additionally, different types of adhd medication medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The effect on a newborn's health is not fully known.
Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult decision for the patient, who must balance the benefit of continuing her medication with the potential dangers to the foetus. Until more information becomes available, GPs may inquire about pregnant patients whether they have a background of ADHD or if they plan to take medication in the perinatal period.
A growing number of studies have shown that most women can safely continue to take their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are opting to do so. They have concluded after consulting with their doctor that the benefits of retaining their current medication outweigh possible risks.
It's important for women with ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior 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 suffering from ADHD recognize their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for managing. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of signs of deterioration, and, if necessary adjustments to the medication regime.