10 Tips To Know About ADHD Medication Pregnancy
10 Tips To Know About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medication during breastfeeding and pregnancy is challenging for women with the condition. Little data exists about how long-term exposure to these drugs could affect the foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental disorders like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the fetus. Doctors don't have enough data to make unambiguous recommendations however they can provide information on risks and benefits to assist pregnant women to make informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers used a vast population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was correct and to reduce any bias.
The research conducted by the researchers was not without its limitations. The most important issue was that they were unable to distinguish the effects of the medication from the disorder that is underlying. That limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to medication use or comorbidities that cause confusion. Researchers also did not look at long-term outcomes for offspring.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies can be offset by more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, when possible, assist them in developing strategies to improve coping skills that may minimize the impact of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the question of whether to keep or stop treatment during pregnancy is one that more and more physicians confront. These decisions are often made without clear and authoritative evidence. Instead, doctors have to consider their own expertise and experience, as well as the experiences of other doctors, and the research that has been conducted on the subject.
In particular, the issue of potential risks to the baby can be tricky. A lot of studies on this subject are based on observational evidence rather than controlled research and their conclusions are often contradictory. The majority of studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
The conclusion is that while some studies have found an association between ADHD medications and the possibility of certain birth defects, others have found no connection and the majority of studies have a neutral or slight negative effect. Therefore, a careful risk/benefit assessment must be done in each instance.
For women suffering from ADHD, the decision to stop taking medication is difficult, if not impossible. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of being isolated. In addition, a decrease in medication can affect the ability to perform job-related tasks and drive safely which are essential aspects of a normal life for a lot of people with ADHD.
She suggests women who are uncertain about whether to continue or stop medication in light of their pregnancy, consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily functioning, and the advantages of continuing the current treatment regimen. It can also help women feel confident about her decision. It is important to remember that some medications can be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug could be transferred to the infant.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers used two massive datasets to analyze more than 4.3 million pregnant women and determine if the use of stimulant medications increased birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.
The researchers of the study could not discover any link between early use of medication and other congenital anomalies, like facial deformities or club feet. The results are in the same vein as 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 pregnancy. The risk increased in the latter part get more info of pregnancy when a large number of women stopped taking their medication.
Women who took ADHD medication in the first trimester were more likely need a caesarean, have a low Apgar after delivery and had a baby that required breathing assistance after birth. However the researchers of the study were unable to eliminate bias due to selection by limiting the study to women who didn't have any other medical conditions that could have contributed to these findings.
Researchers hope their research will provide doctors with information when they meet pregnant women. The researchers suggest that, while discussing risks and benefits are crucial, the decision about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also caution that, while stopping the medication is an option, it is not an option to consider due to the high incidence of depression and other mental health issues in women who are pregnant or post-partum. Additionally, the research suggests that women who choose to stop their medications are more likely to have difficulties getting used to life without them after the baby's arrival.
Nursing
It can be overwhelming to become a mom. Women with ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed through breast milk in small amounts, so the risk for breastfeeding infant is minimal. However, the rate of exposure to medications by the newborn can vary depending on dosage, frequency it is administered, and the time of the day it is administered. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The effect on the health of a newborn is not fully understood.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. It's a difficult choice for the mother, who must weigh the benefits of her medication against the risk to the embryo. In the meantime, until more information is available, doctors may inquire about pregnant patients whether they have an history of ADHD or if they are planning to take medication during the perinatal stage.
A growing number of studies have proven that the majority of women are able to safely continue their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are opting to do so. They have discovered, in consultation with their physicians, that the benefits of keeping their current medication outweigh risk.
It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help women with ADHD understand their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for coping. This should include an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include 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 regime.