ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how exposure to ADHD for a long time could affect a fetus.

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

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against potential risks to the fetus. Physicians don't have the data to give clear advice however they can provide information about risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large population-based case-control study to determine the prevalence of major structural birth defects in infants 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 make sure that the classification was accurate and to reduce any bias.

However, the study was not without its flaws. The researchers were unable to, in the first place to distinguish the effects caused by the medication from the disorder. That limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to the use of medication or confounding by comorbidities. In addition, the researchers did not study the long-term outcomes of offspring.

The study revealed that infants whose mother took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean birth or having a baby born with an low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

Researchers suggest that the small risk of using 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. Doctors should discuss with their patients about this and as much as possible, assist them improve coping skills which may reduce the effects of her disorder on her daily functioning and her relationships.

Interactions with best medication for ocd and adhd

As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is a question that more and more physicians have to face. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must weigh their own knowledge, the experience of other doctors and the research on the subject.

The issue of potential risks to the infant can be difficult to determine. The research that has been conducted on this topic is based on observation rather than controlled studies and a lot of the results are contradictory. most common adhd medications (olderworkers.com.au) studies focus on live births, which can adhd medication help with memory underestimate the severity of teratogenic effects that can lead to terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these issues by analyzing the data from deceased and live births.

The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no such relationship, and most studies show a neutral or even slightly negative effect. In the end, a careful risk/benefit analysis must be done in each case.

It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of isolation. Furthermore, a loss of medication can affect the ability to perform job-related tasks and drive safely which are essential aspects of a normal life for many people suffering from ADHD.

She suggests women who are unsure about whether to keep or stop medication in light of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. Educating them can also aid in ensuring that the woman feels supported in her struggle with her decision. It is important to remember that certain medications can pass through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be transferred to the child.

Birth Defects Risk

As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Using 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. Researchers discovered that although the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The authors of the study could not discover any connection between early medication usage and other congenital anomalies, such as facial deformities or club feet. The results are in agreement with previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the birth of their child. The risk increased in the latter half of pregnancy, when a lot of women decided to stop taking their medication.

Women who took ADHD medication in the first trimester were more likely to need a caesarean or have a low Apgar after delivery, and have a baby that needed help breathing after birth. However, the authors of the study were not able 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 the findings.

Researchers hope that their study will help doctors when they encounter pregnant women. They suggest that although the discussion of the benefits and risks is important however, the decision to stop or keep treatment must be based on each woman's needs and the severity of her ADHD symptoms.

The authors also warn that while discontinuing the medications is an alternative, it is not an option to consider due to the high incidence of depression and other mental health issues for women who are expecting or recently postpartum. Additionally, the research suggests that women who decide to stop taking their medications 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 with ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments, 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 medications are absorbed by breast milk in low amounts, so the risk to nursing infant is very low. The rate of medication exposure will differ based on dosage the best medication for adhd is administered, its frequency and time of day. In addition, various medications enter the baby’s system through the gastrointestinal tract or through breast milk. The effect on a newborn's health is not completely comprehended.

Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the benefits of her medication against the potential risks to the embryo. As long as there is no more information, doctors should inquire with all pregnant patients about their history of ADHD and whether they are taking or planning 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 concluded after consulting with their physicians, that the benefits of keeping their current medication outweigh any risk.

Women who suffer from adhd medication how does it work who are planning to nurse should seek advice from an expert psychiatrist prior to 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 underlying disorder. They should also learn about treatment options and strengthen the coping mechanisms. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both the mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.