5 Laws Anyone Working In ADHD Medication Pregnancy Should Know

ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medication during pregnancy and breastfeeding is a challenge for women suffering from the condition. There are few data regarding how exposure over time may affect a pregnant fetus.

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 more high quality research is needed.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication must weigh the benefits of taking it versus the dangers for the foetus. Physicians do not have the necessary data to provide clear recommendations, but they can provide information about benefits and risks that can aid pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not face an increased risk of fetal heart malformations or major birth defects that are structural. 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 in the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was correct and to eliminate any bias.

The study conducted by the researchers was not without its limitations. The researchers were not able in the beginning to differentiate the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the small associations observed among the exposed groups were due to medication use or if they were confounded by comorbidities. The researchers did not examine long-term outcomes for the offspring.

The study showed that infants whose mothers took ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to those whose mothers did not take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. This was due to central nervous system-related disorders and the increased risk for admission did not appear to be affected by the type of stimulant medications were used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or a baby that scored low on the Apgar scale (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the small risks associated with the use ADHD medications in early pregnancies can be offset by greater benefits for mother and baby of continuing treatment for the woman’s disorder. Doctors should discuss with their patients about this issue and as much as possible, assist them develop coping strategies that can lessen the impact of her disorder in her daily life and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to keep or end treatment during pregnancy is a question that more and more physicians have to face. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to consider their own expertise, the experience of other physicians and the research that has been conducted on the subject.

The issue of possible risks to the infant can be difficult to determine. The research on this issue is based on observations rather than controlled studies and a lot of the results are contradictory. In addition, most effective adhd medication for adults studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations by analyzing information on deceased and live births.

The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have found no connection, and most studies show a neutral or even slightly negative effect. In the end, a careful risk/benefit assessment must be done in each case.

For a lot of women with ADHD who suffer from ADHD, the decision to stop taking medication can be difficult, if not impossible. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of isolation. Additionally, the loss of medication may affect the ability to complete jobs and drive safely that are crucial aspects of daily life for a lot of people with ADHD.

She suggests that women who are unsure whether to take the medication or stop due to pregnancy educate family members, colleagues, and acquaintances about the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. In addition, educating them can make the woman feel more comfortable in her struggle dealing with adhd without medication her decision. Certain medications can be passed through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is crucial to be aware that the drug could be passed on to her baby.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns over the impact that these drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two huge datasets to analyze over 4.3 million pregnant women and determine if the use of stimulant medications increased the risk of birth defects. While the overall risk remains low, the scientists discovered that the first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects, like ventriculo-septal defects (VSD).

The researchers of the study could not find any association between the use of early medications and congenital anomalies like facial deformities or club feet. The results are in line with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the time of pregnancy. The risk was higher during the latter part of pregnancy, as many women begin to discontinue their ADHD medication.

Women who took ADHD medications during the first trimester of their pregnancy were also more likely to have caesarean section, low Apgar score following delivery, and a baby that required breathing assistance during birth. However, the authors of the study were unable to eliminate selection bias by limiting the study to women who did not have any other medical issues that could have contributed to the findings.

Researchers hope their research will help doctors when they encounter pregnant women. The researchers suggest that, while discussing risks and benefits are important, the choice 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 warn that, even though stopping the medication is a possibility to look into, it is not advised due to the high rate depression and mental health issues for women who are pregnant or recently gave birth. Furthermore, research suggests that women who decide to stop their medications are more likely to have difficulties getting used to life without them after the birth of their baby.

Nursing

It can be a challenge becoming a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, getting ready for the arrival of a baby 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 the course of pregnancy.

The majority of stimulant medicines are absorbed through breast milk in very small amounts, therefore the risk to infant who is breastfeeding is low. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of 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 is not yet fully understood.

Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefits of keeping her medication with the potential dangers to the fetus. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and if they plan or are taking to take medication for Adhd and Bipolar during the perinatal period.

A growing number of studies have proven that most common adhd medications women can safely continue taking their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are opting to do this. They have concluded after consulting with their physicians that the benefits of retaining their current medication outweigh potential risks.

Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and reinforce coping mechanisms. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.