ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how long-term exposure may affect the fetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders like hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication need to evaluate the benefits of using it against the possible dangers for the foetus. Doctors don't have the information needed to provide clear recommendations, but they can provide information regarding benefits and risks that can assist pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a large sample-based case control study to assess the frequency of major structural defects in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure correct case classification and to limit the possibility of bias.

The study of the researchers was not without limitations. Most important, they were unable to separate the effects of the medication from the effects of the disorder that is underlying. That limitation makes it difficult to determine whether the small differences observed in the groups that were exposed result from medication use or confounding by comorbidities. The researchers did not study the long-term effects for the offspring.

The study revealed that infants whose mothers had taken adhd uk medication medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers didn't take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This was due to central nervous system-related disorders and the increased risk for admission was not found to be affected by the type of stimulant medications were used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean birth or having a baby with a low Apgar score (less than 7). These risks did not appear to be affected by the type of medication that was used during pregnancy.

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

Medication Interactions

Many doctors are confronted with the dilemma of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are usually made without clear and authoritative evidence. Instead, doctors must weigh their own knowledge, the experience of other doctors, and the research on the topic.

Particularly, the issue of possible risks to the baby can be a challenge. Many of the studies on this issue are based on observations rather than controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which could undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations, by examining both data on live and deceased births.

The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies have a neutral or slight negative effect. As a result an accurate risk-benefit analysis is required in every instance.

For women suffering from ADHD, the decision to stop taking medication is difficult if not impossible. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of being isolated. A loss of medication may also impact the ability to safely drive and to perform work-related tasks which are crucial aspects of daily life for people with ADHD.

She recommends women who are uncertain about whether to continue or discontinue medication due to their pregnancy consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and the advantages of staying on the current treatment regimen. In addition, educating them can help the woman feel supported as she struggles with her decision. Certain medications can pass through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug could be passed on to her baby.

Birth Defects and Risk of

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns over the impact that these drugs might have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two massive datasets to analyze over 4.3 million pregnant women and determine if the use of stimulant medications increased birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.

The authors of 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 consistent with previous studies showing an increase, but not significant, in the risk of developing cardiac malformations among women who started taking ADHD medications before pregnancy. The risk grew during the latter part of pregnancy, when many women decide to stop taking their ADHD medication.

Women who were taking ADHD medication during the first trimester were more likely require a caesarean delivery or have an insufficient Apgar after delivery, and had a baby that required breathing assistance when they were born. The authors of the study were unable to eliminate selection bias because they restricted the study to women without other medical conditions that might have contributed to the findings.

The researchers hope that their research will help inform the clinical decisions types of adhd medication physicians who see pregnant women. They suggest that although discussing the risks and benefits is crucial but the decision to stop or maintain medication should be based on each woman's requirements 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 in women who are pregnant or postpartum. Research has also shown that women who stop taking their medication will have a difficult transitioning to life without them once the baby is born.

Nursing

The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must deal with their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs are absorbed through breast milk in small amounts, so the risk to infant who is breastfeeding is low. However, the amount of medication exposure to the newborn can vary depending on dosage, how often it is administered, and the time of day the medication is administered. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The effect on a newborn's health is not completely understood.

Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication with the potential risks to the fetus. In the meantime, until more information is available, GPs can ask pregnant patients whether they have an history of ADHD or if they are planning to take medication in the perinatal phase.

Numerous studies have demonstrated that women can continue taking their ADHD medication safely during pregnancy and breast-feeding. This has led to many patients opt to do this and after consulting with their doctor, they have found that the benefits of continuing their current medication outweigh any potential risks.

Women with ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if needed adjustments to the medication regimen.