10 Times You'll Have To Learn About ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies regarding how exposure over time may affect the fetus.

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 that further high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the benefits of taking them against the potential 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 aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large population-based study of case control to examine the prevalence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. 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. Researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. That limitation makes it difficult to determine whether the small associations observed in the groups that were exposed are due to medication use or confounding by comorbidities. The researchers also did not examine long-term outcomes for the offspring.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medication was used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean delivery or having a baby with an low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.

The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both mother and child of continuing treatment for the woman's condition. Physicians should speak with their patients about this issue and as much as possible, assist them develop coping skills that may reduce the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is a question that more and more physicians confront. The majority of these decisions are made without solid and reliable evidence in either case, which means that doctors must weigh what they know from their own experiences, those of other doctors, and what the research says on the topic, along with their own judgments for each patient.

Particularly, the subject of possible risks to the baby can be tricky. A lot of studies on this topic are based on observations rather than controlled research, and their conclusions are often contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study presented in this journal club addresses these shortcomings by analyzing data on live and deceased births.

Conclusion: While some studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown that there is a neutral, or slightly negative, effect. In the end, a careful risk/benefit assessment must be conducted in every situation.

For a lot of women with ADHD and ADD, the decision to stop medication is difficult if not impossible. In fact, in an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for patients with ADHD. Furthermore, a loss of medication may affect the ability to do work-related tasks and safely drive, which are important aspects of daily life for many people suffering from ADHD.

She suggests women who are unsure about whether or not to stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. It can also help women feel more confident in her decision. Some medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be transferred to the baby.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns over the impact that these medications could have on the fetuses.  medications for adhd uk  published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Using two massive data sets, researchers were able to examine more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increased risk of specific heart defects, such as ventriculoseptal defect (VSD).

The researchers behind the study found no connection between the use of early medications and other congenital abnormalities, such as facial clefting or club foot. The results are in line with previous studies showing a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications before the birth of their child. This risk increased during the latter stages of pregnancy, when a lot of women began to stop taking their medication.

Women who took ADHD medication during the first trimester were more likely need a caesarean or have an insufficient Apgar after delivery and have a baby who needed breathing assistance after birth. The authors of the study were not able to eliminate bias due to selection because they limited their study to women who did not have any other medical conditions that might have contributed to the findings.

Researchers hope that their study will inform physicians when they encounter pregnant women. The researchers suggest that, while discussing the risks and benefits are important, the decision about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her needs.

The authors also warn that while discontinuing the medications is an option, it is not an option that is recommended due to the high incidence of depression and other mental health issues in women who are pregnant or recently post-partum. Furthermore, research suggests that women who decide to stop taking their medication are more likely to have difficulties adapting to life without them following the baby's arrival.

Nursing

It can be a stressful experience to become a mother. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. 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, therefore the risk for breastfeeding infant is minimal. However, the frequency of exposure to medication by the infant can differ based on dosage, how often it is administered, and the time of day it is administered. Additionally, different medications enter the baby's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn isn't well known.

Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the absence of research. It's a difficult choice for the mother, who must weigh the advantages of taking her medication as well as the risk to the embryo. As long as more information is available, doctors may inquire about pregnant patients whether they have any history of ADHD or if they plan to take medication during the perinatal period.

Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, an increasing number of patients are opting to do this. They have found, in consultation with their physicians that the benefits of keeping their current medication far outweigh any risk.

Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder and learn about treatment options and strengthen existing coping strategies. This should include an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, as well as monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regimen.