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ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how long-term exposure to these medications can affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental disorders like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are needed.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication must consider the benefits of taking it against the possible risks to the fetus. Physicians do not have the data needed to provide clear recommendations however they can provide information regarding benefits and risks that can assist pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists examined the cases to ensure accurate case classification and to limit the possibility of bias.

However, the researchers' study had its limitations. The researchers were unable in the beginning to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine if the small associations observed among the exposed groups were due to the use of medications, or if they were confounded by the presence of comorbidities. The researchers also did not look at the long-term effects for the offspring.

The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders, and the higher risk of admission was not found to be influenced by which stimulant medications were used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean delivery or having a baby with an low Apgar score (less than 7).  medications for adhd uk  appear to be independent of the type of medication used during pregnancy.

The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefits to both mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this and try to help them develop coping skills that could reduce the effects of her disorder on her daily life and relationships.

Interactions with Medication

As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether or not to end treatment during pregnancy is one that doctors are having to confront. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive regardless, so doctors must weigh what they know, the experiences of other doctors, and what the research says on the topic, along with their best judgment for each patient.

The issue of risk to the infant can be difficult to determine. The research that has been conducted on this topic is based on observation instead of controlled studies and a lot of the results are in conflict. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.

Conclusion: While some studies have shown an association between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. Most studies have shown an unintended, or slight negative impact. In the end, a careful risk/benefit assessment must be done in each case.

For many women with ADHD and ADD, the decision to stop taking medication is difficult if not impossible. In an article published in the 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 patients with ADHD. Additionally, the loss of medication may affect the ability to perform work-related tasks and safely drive, which are important aspects of a normal life for many people suffering from ADHD.

She suggests that women who are unsure whether to continue taking the medication or stop due to pregnancy educate family members, coworkers and acquaintances about the condition, the impact on daily functioning and the advantages of staying on the current treatment regimen. It can also help women feel more confident in her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be passed on to her infant.

Risk of Birth Defects

As the use and use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the potential effects of these drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. With two massive data sets researchers were able look at more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects, such as ventriculoseptal defect (VSD).

The researchers of the study didn't discover any link between the use of early medications and other congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the birth of their child. The risk increased in the latter half of pregnancy, when a lot of women stopped taking their medication.

Women who were taking ADHD medication during the first trimester were more likely need a caesarean or have a low Apgar after birth and had a baby that required help breathing at birth. However the authors of the study were not able to eliminate selection bias by limiting the study to women who did not have other medical issues that could have contributed to the findings.

The researchers hope their study will aid in the clinical decisions of doctors who see pregnant women. They recommend that, while a discussion of the risks and benefits is crucial however, the decision to stop or continue medication should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, although stopping the medication is a possibility to consider, it is not advised because of the high incidence of depression and other mental disorders for women who are pregnant or recently gave birth. Additionally, the research suggests that women who decide to stop their medications are more likely to experience a difficult time adjusting to life without them following the baby's arrival.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women suffering from ADHD can face severe challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. This is why many women elect to continue taking their ADHD medication throughout the pregnancy.

The majority of stimulant drugs are absorbed by breast milk in very small quantities, so the risk to the nursing infant is very low. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and the time of the day. In addition, various drugs enter the infant's system via the gastrointestinal tract, or through breast milk. The impact on the health of a newborn is not completely comprehended.

Because of the lack of evidence, some doctors may be inclined to discontinue stimulant drugs during the course of pregnancy. It's a difficult choice for the woman who must weigh the advantages of her medication against the risk to the foetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal time.

A increasing number of studies have shown that women can continue their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are choosing to do so. They have discovered, in consultation with their physicians, that the benefits of keeping their current medication outweigh any potential risks.

It's important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help women with ADHD understand their symptoms and underlying disorder, learn about available treatment options and reinforce existing strategies for managing. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if needed modifications to the medication regimen.