20 Myths About ADHD Medication Pregnancy: Dispelled
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during breastfeeding and pregnancy is challenging for women with the condition. There isn't much information on how long-term exposure to these drugs could affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, 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 need to balance the advantages of taking them against potential risks to the foetus. The doctors don't have the information to provide clear recommendations, but can provide information on the risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers used a vast population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was accurate and to reduce any bias.
However, the study had its limitations. In particular, they were unable to distinguish the effects of the medication from those of the underlying disorder. This limitation makes it difficult to know whether the small differences observed in the groups that were exposed result from medication use or comorbidities that cause confusion. In addition the study did not examine the long-term outcomes of offspring.
The study showed that infants whose mother had taken ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy or had quit taking the 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 were also at an increased risk of having a caesarean delivery or having a baby with an low Apgar score (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the higher benefit to both the mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, if possible, assist them in developing strategies for improving their coping skills that may minimize the effects of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly confronted dealing with adhd without medication the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge in conjunction with the experiences of other physicians and the research that has been conducted on the subject.
In particular, the issue of possible risks to the baby can be a challenge. The research that has been conducted on this topic is based on observations instead of controlled studies and the results are in conflict. Additionally, the majority of studies limit their analysis to live births, which may underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations by analyzing data on live and deceased births.
The conclusion: While some studies have shown an association between ADHD medications and the risk of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slightly negative impact. In each case, a careful analysis of the risks and benefits should be conducted.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can i Get Adhd Meds without A diagnosis cause depression, feelings of isolation, and family conflict for patients with ADHD. A loss of medication may affect the ability to drive safely and to perform work-related tasks which are essential aspects of everyday life for those with ADHD.
She suggests that women who are not sure whether to take the medication or stop it due to their pregnancy should educate family members, coworkers and their friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment plan. Educating them can also make the woman feel more comfortable as she struggles with her decision. Some medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug may be transferred to her baby.
Risk of Birth Defects
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (adhd medications for adults with anxiety) is increasing the concern over the possible effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Utilizing two huge data sets, researchers were able to look at more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.
The researchers of the study did not find any association between the use of early medications and other congenital anomalies such as facial deformities or club feet. The results are in line with previous studies that have shown a small but significant increase in the risk of heart malformations in women who started taking ADHD medications prior to pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who were taking ADHD medication during the first trimester were more likely to need a caesarean and also have an insufficient Apgar after birth and have a baby who needed help breathing after birth. However the researchers of the study were unable to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could be a contributing factor to these findings.
Researchers hope that their study will inform physicians when they see pregnant women. The researchers suggest that while discussing the risks and benefits are crucial, the decision on whether to continue or stop taking medication should be based on the severity of each woman's ADHD symptoms and her requirements.
The authors caution that, even though stopping the medication is an option to consider, it is not recommended because of the high incidence of depression and other mental problems for women who are pregnant or recently gave birth. Additionally, the research suggests that women who decide to stop their medications are more likely to have difficulties adjusting to life without them following the baby's arrival.
Nursing
It can be overwhelming to become a mom. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to a new routine. As such, many women choose to continue taking their natural adhd medication medications throughout pregnancy.
The risk to a nursing infant is low because the majority of stimulant medications passes through breast milk in low amounts. The rate of medication exposure can vary depending upon the dosage and frequency of administration as well as the time of the day. In addition, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn is not completely understood.
Because of the lack of research, some doctors may recommend stopping stimulant medications during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the benefits of her medication against the risks to the embryo. Until more information is available, doctors should ask all pregnant patients about their history of add adhd medications and if they plan or are taking to take medication during the perinatal period.
Many studies have shown that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. This has led to many patients opt to do this and, after consulting with their doctor, they have discovered that the benefits of continuing their current medication exceed any risk.
Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should include a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.