It s The Complete Cheat Sheet For ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during pregnancy and nursing is challenging for women with the condition. There isn't much information on how adhd medication works long-term exposure to these drugs could affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental disorders like hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the benefits of using them against the risks to the fetus. Doctors don't have enough data to provide clear recommendations but they can provide information on the risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a greater risk of fetal malformations or structural birth defects. Researchers conducted a large sample-based case control study to assess the frequency of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure accurate case classification and to limit the possibility of bias.
However, the study was not without its flaws. The most important issue was that they were unable to separate the effects of the medication from those of the disorder at hand. That limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or the confounding effect of comorbidities. Additionally the study did not examine long-term offspring outcomes.
The study did show 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 whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases did not appear to be influenced by the kind of medication used during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medication during pregnancies in the early stages may be offset by the greater benefits for baby and mother of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when they are able, assist them in developing strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships.
Interactions with Medication
Many doctors are faced with the decision of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors must weigh what they know about their experiences, the experiences of other doctors, and what research suggests about the subject, along with their best judgment for each patient.
The issue of potential risks to infants is particularly tricky. A lot of studies on this subject are based on observations instead of controlled research and their conclusions are often contradictory. The majority of studies limit their analysis to live-births, which could underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study presented in the journal club addresses these limitations, by examining both the data from deceased and live births.
Conclusion A few studies have found an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown that there is a neutral, or slight negative effect. In the end, a careful risk/benefit assessment must be done in each situation.
For women suffering from ADHD, the decision to discontinue medication for adhd is difficult if not impossible. In a recent article published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping adhd medication guide medications during pregnancy can cause depression and feelings of being isolated. The loss of medication can affect the ability to safely drive and perform work-related tasks, which are vital aspects of daily life for people with ADHD.
She suggests that women who aren't sure whether to take the medication or stop it due to their pregnancy should educate family members, colleagues, and acquaintances about the condition, its impact on daily functioning and the benefits of keeping the current treatment plan. It will also help a woman feel confident about her decision. Certain medications can pass through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication could be transferred to the infant.
Risk of Birth Defects
As the use and use of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (strongest adhd medication) is increasing, so does concern about the possible effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. With two massive data sets researchers were able look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, like ventriculo-septal defects (VSD).
The researchers behind the study found no connection between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies revealing an increase, but not significant, in the risk of heart malformations in women who started taking ADHD medications prior to the time of pregnancy. This risk increased during the latter half of pregnancy when many women stopped taking their medication.
Women who took ADHD medication during the first trimester were more likely need a caesarean or have a low Apgar after delivery and have a baby who needed help breathing after birth. The authors of the study were not able to eliminate bias due to selection because they restricted the study to women without other medical conditions that could have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of physicians who see pregnant women. The researchers recommend that, while discussing benefits and risks are crucial, the decision regarding whether or not to stop medication should be made according to the severity of each woman's ADHD symptoms and her requirements.
The authors caution that, even though stopping the medication is an option to look into, it is not recommended because of the high incidence of depression and other mental problems in women who are expecting or have recently given birth. Additionally, research suggests that women who stop taking their medication will have a harder adjustment to life without them once the baby is born.
Nursing
It can be overwhelming becoming a mother. Women with ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to a new adhd medication routine. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at a low level. However, the amount of exposure to medication by the newborn can vary depending on the dosage, frequency it is taken and at what time the medication is administered. In addition, different medications are introduced into the baby's system via the gastrointestinal tract or breast milk. The impact on a newborn's health is not completely known.
Because of the lack of research, some doctors may recommend stopping stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must balance the benefits of keeping her medication against the possible risks to the foetus. As long as more information is available, doctors can inquire about pregnant patients if they have a background of ADHD or if they plan to take medication during the perinatal stage.
Numerous studies have demonstrated that women can continue to take their ADHD medication without risk while breastfeeding and during pregnancy. In response, a growing number of patients are choosing to continue their medication. They have found after consulting with their doctors that the benefits of keeping their current medication far outweigh any possible risks.
Women with ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and build strategies for coping. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatry. Pregnancy counselling should include discussion of a management plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.