The Top Reasons For ADHD Medication Pregnancy s Biggest "Myths" About ADHD Medication Pregnancy Could Be True
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There are few data on how exposure to ADHD for a long time could affect a foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the advantages of using them against the risks to the fetus. Doctors don't have enough data to provide clear recommendations, but can provide information about risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a large sample-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was correct and to reduce any bias.
The research conducted by the researchers had some limitations. The researchers were not able in the beginning to differentiate the effects triggered by the medication from the disorder. That limitation makes it difficult to know whether the small associations observed in the groups that were exposed are due to the use of medication or the confounding effect of comorbidities. Additionally, the researchers did not examine the long-term outcomes of offspring.
The study showed that infants whose mothers took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared to those whose mothers didn't take any medication during pregnancy or stopped taking their medication before or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk for admission was not found to be influenced by which stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both the mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve coping skills that can lessen the impact of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is one that doctors are having to have to face. These decisions are usually made without clear and reliable evidence. Instead, doctors must weigh their own knowledge in conjunction with the experiences of other physicians and the research on the topic.
The issue of potential risks to the infant can be difficult to determine. Many of the studies on this subject are based on observational data instead of controlled research and their findings are often contradictory. Furthermore, most effective adhd medication studies restrict their analysis to live births, which could underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by examining data on both live and deceased births.
The conclusion is that while certain studies have demonstrated that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies have a neutral or slightly negative impact. In every case, a careful analysis of the risks and benefits must be performed.
For many women with ADHD, the decision to stop medication can be difficult, if not impossible. In an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping liquid adhd medication medication during pregnancy can lead to increased depression, feelings of loneliness and family conflict for patients with ADHD. A decrease in medication could affect the ability to safely drive and to perform work-related tasks which are vital aspects of everyday life for people with inattentive adhd medication.
She recommends women who are uncertain about whether to keep or stop taking medication because of their pregnancy, consider informing family members, friends, and coworkers on the condition, its effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also help a woman feel supported in her decision. Some medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the medication may be transferred to her baby.
Risk of Birth Defects
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about the effects that the drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. With two massive data sets researchers were able look at more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects.
The authors of the study could not discover any connection between the use of early medications and other congenital anomalies, like facial deformities, or club feet. 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 pregnancy. The risk was higher in the latter half of pregnancy, when many women begin to discontinue their ADHD medications.
Women who used ADHD medications in the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who needed breathing assistance at birth. The researchers of the study could not remove bias in selection since they limited their study to women without other medical conditions that might have contributed to the findings.
The researchers hope that their research will help inform the clinical decisions of doctors who can prescribe adhd medication for Adults see pregnant women. The researchers recommend that while discussing risks and benefits are crucial, the decision regarding whether or not to stop medication should be based on the severity of each woman's ADHD symptoms and her requirements.
The authors also caution that even though stopping the medication is an option, it isn't an option to consider due to the high rate of depression and other mental health issues among women who are pregnant or who are recently postpartum. Research has also shown that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments and getting ready for the arrival of their child and adapting to new routines in the home are often faced with a number of difficulties. As such, many women elect to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small quantities, so the risk to the nursing infant is very low. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and the time of the day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not fully known.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the lack of research. It is a difficult decision for the woman, who must weigh the advantages of her medication against the potential risks to the embryo. In the meantime, until more information is available, doctors may inquire about pregnant patients whether they have an history of ADHD or if they plan to take medication during the perinatal phase.
Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In the end, more and more patients choose to do so and, in consultation with their physician, they have found that the benefits of keeping their current medication outweigh any risks.
It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-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 educated about treatment options and strengthen strategies for coping. This should involve a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration and, if necessary adjustments to the medication regimen.