ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how long-term exposure to these drugs could affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the advantages of taking them against potential risks to the fetus. Physicians don't have the data needed to give clear guidelines however they can provide information about the risks and benefits to assist pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy and those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to minimize the chance of bias.
However, the researchers' study was not without its flaws. Most important, they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This makes it difficult for researchers to determine whether the small differences observed between the groups that were exposed to the use of medication or if they were confounded by co-morbidities. Researchers also did not study the long-term effects for the offspring.
The study did reveal that infants whose mothers took ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a baby born with a low Apgar score (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 risk of using ADHD medications in early pregnancies can be offset by more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and, if possible, help them develop coping strategies that can lessen the effects of her disorder on her daily life and relationships.
Interactions with Medication
As more women than ever are diagnosed with ADHD and being treated with medication, the dilemma of whether or not to end treatment during pregnancy is one that doctors are having to have to face. Often, these decisions are made in the absence of clear and authoritative evidence either way, so physicians must weigh what they know, the experiences of other doctors, and what research suggests on the subject as well as their best judgment for each patient.
The issue of risk for infants can be difficult to determine. A lot of studies on this subject are based on observational data rather than controlled research, and their conclusions are often contradictory. Most studies focus on live-births, which could underestimate the severity of teratogenic effects that can lead to abortions or terminations of pregnancy. The study discussed in the journal club addresses these limitations by analyzing both information on deceased and live births.
The conclusion The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no connection, and most studies demonstrate a neutral or slightly negative impact. As a result an accurate risk-benefit analysis must be done in each case.
For a lot of women with ADHD who suffer from ADHD, the decision to stop medication is difficult, if not impossible. In a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness and family conflict for those suffering from the disorder. Furthermore, a loss of medication can interfere with the ability to perform work-related tasks and safely drive which are essential aspects of daily life for a lot of people with ADHD.
She suggests that women who are unsure whether to take the medication or discontinue it due to pregnancy should educate family members, coworkers and their friends about the condition, its impact on daily functioning and the benefits of continuing the current treatment regimen. Educating them can i get adhd medication without a diagnosis also help the woman feel supported when she is struggling with her decision. It is also worth noting that some drugs can be absorbed through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug can be transferred to the child.
Risk of Birth Defects
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the drugs could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medications was linked to a slightly higher rate of certain heart defects, such as ventriculo-septal defect (VSD).
The researchers behind the study found no link between early use of medication and other congenital anomalies, like facial clefting, or club foot. The results are consistent with previous studies revealing a small but significant increase in the risk of developing cardiac malformations among women who started taking ADHD medications before pregnancy. The risk increased in the latter part of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medications during the first trimester of their pregnancy were also more likely to have caesarean section, low Apgar score after delivery and a baby who required breathing assistance at birth. The researchers of the study were unable to remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope their research will inform physicians when they see pregnant women. The researchers suggest that while discussing the risks and benefits are crucial, the decision about whether to continue or stop taking medication should be according to the severity of each woman's adhd treatment medication symptoms and her requirements.
The authors also advise that even though stopping adhd medication private prescription medication adults (simply click the up coming document) the medication is an option, it is not an option that is recommended due to the high incidence of depression and other mental health problems in women who are pregnant or post-partum. Additionally, research suggests that women who stop taking their medication will have a difficult adjustment to life without them once the baby is born.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD can face severe challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed by breast milk in very small amounts, so the risk to infant who is breastfeeding is low. The rate of exposure to medication 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 as well as breast milk. The impact of this on a newborn isn't well understood.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult choice for the patient, who must balance the benefit of continuing her medication against the potential dangers to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal period.
A growing number of studies have shown that women can continue their ADHD medication given for adhd during pregnancy and while breastfeeding. In response, a rising number of patients are choosing to continue their medication. They have found through consultation with their physicians that the benefits of keeping their current medication far outweigh any potential risks.
Women with ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also be informed about treatment options and build strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatrists. The pregnancy counselling should consist of the discussion of a plan for management for both mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.