ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these medications may affect the foetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication need to evaluate the benefits of using it versus the dangers for the baby. Physicians don't have the data needed to provide clear recommendations, but they can provide information regarding the risks and benefits to assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large sample-based case control study to examine the prevalence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to make sure that the classification was accurate and to eliminate any bias.

The study of the researchers had some limitations. In particular, they were unable to separate the effects of the medication from those of the disorder that is underlying. This 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. The researchers also did not look at long-term outcomes for offspring.

The study showed that infants whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy or quit taking the medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the minor risks posed by the use of adhd medication how does it work medications in early pregnancies could be offset by the greater benefits for mother and baby from continuing treatment for the woman's condition. Doctors should discuss with their patients about this and, if possible, help them improve coping skills which could reduce the impact of her disorder in her daily life and relationships.

Medication Interactions

As more women than ever before are being diagnosed with managing adhd without medication adults and treated with medication, the question of whether to continue or stop treatment during pregnancy is one that more and more doctors have to face. Often, these decisions are taken in the absence of clear and authoritative evidence either way, so physicians have to weigh their experience about their experiences, the experiences of other doctors, and what the research suggests about the subject as well as their own judgments for each individual patient.

Particularly, the subject of possible risks to the baby can be a challenge. The research on this subject is based on observations rather than controlled studies, and a lot of the results are conflicting. The majority of studies limit their analysis to live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.

The conclusion The conclusion: While some studies have shown an association between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies show a neutral or even slightly negative effect. In every case it is imperative to conduct a thorough evaluation of the risks and benefits should be conducted.

It can be challenging, 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 private prescription medication during pregnancy can cause depression, feelings of loneliness and family conflict for these patients. In addition, a decrease in medication can affect the ability to complete jobs and drive safely, which are important aspects of daily life for many people suffering from mild adhd medication.

She suggests that women who are not sure whether to continue taking the medication or stop due to pregnancy educate family members, coworkers and acquaintances about the condition, its impact on daily functioning and the benefits of continuing the current treatment regimen. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the medication may be transferred to her baby.

Risk of Birth Defects

As the use of ADHD medication to treat adhd without medication adults the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns over the impact that these drugs could have on foetuses. 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 analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.

The researchers of the study found no association between early medication use and congenital abnormalities such as facial clefting or club foot. The results are in the same vein as previous studies which showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. This risk increased in the later part of pregnancy, when a lot of women begin to discontinue their ADHD medication.

Women who took ADHD medications during the first trimester of pregnancy were also more likely to experience caesarean section, low Apgar score following delivery, and a baby that required breathing assistance at birth. The authors of the study could not eliminate selection bias because they limited their study to women without other medical conditions that could have contributed to the findings.

The researchers hope that their research will help inform the clinical decisions of doctors who treat pregnant women. They suggest that although discussing risks and benefits is important but the decision to stop or continue medication should be based on the woman's needs and the severity of her ADHD symptoms.

The authors also warn that while discontinuing the medications is an option, it isn't a recommended practice because of the high rate of depression and other mental health issues in women who are pregnant or postpartum. Further, the research suggests that women who choose to stop taking their medication are more likely to experience difficulties getting used to life without them after the birth of their baby.

Nursing

The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments and making preparations for the arrival of a baby and adjusting to new household routines can experience severe challenges. As such, many women choose to continue taking their ADHD medications throughout pregnancy.

The majority of stimulant medications are absorbed through breast milk in small amounts, so the risk to the breastfeeding infant is minimal. However, the rate of exposure to medications by the infant can differ based on dosage, frequency it is administered and the time of the day the medication is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not well known.

Because of the lack of research, some doctors may recommend stopping stimulant medications during the pregnancy of a woman. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication against the possible risks to the embryo. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.

Numerous studies have proven that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. In response, a rising number of patients are opting to do this. They have discovered, in consultation with their doctors that the benefits of retaining their current medication outweigh any potential 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 discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and strengthen coping mechanisms. This should involve a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include discussion of a management plan for both the mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.