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 breastfeeding. There aren't many studies on how long-term exposure may affect a pregnant fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss 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 advantages of using them against the risks to the foetus. Doctors don't have enough data to provide clear recommendations but they can provide information about risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers used a large population-based case control study to examine the prevalence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to limit the possibility of bias.

However, the study was not without its flaws. The researchers were not able, in the first place to distinguish the effects caused by the medication from the disorder. This makes it difficult for researchers to determine whether the small differences observed between the groups that were exposed to the use of medication, or if they were confounded by comorbidities. The researchers did not look at the long-term effects for the offspring.

The study did show that infants whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or stopped their medications before or during pregnancy. This was due to central nervous system-related disorders, and the higher risk of admission was not found to be influenced by the stimulant medications were taken during pregnancy.

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

The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit for both mother and child from continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies for improving their coping skills which can reduce the negative impact of her condition on her daily life and relationships.

Medication Interactions

Many doctors are faced with the decision of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of clear and authoritative evidence either way, so physicians must weigh their knowledge, the experiences of other doctors, and what research says on the topic, along with their best judgment for each patient.

Particularly, the subject of possible risks to the infant can be difficult. The research on this subject is based on observation rather than controlled studies, and many of the findings are in conflict. The majority of studies focus on live births, which can underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these limitations by analyzing both information on deceased and live births.

Conclusion Some studies have shown an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show a neutral, or even somewhat negative, impact. In the end an accurate risk-benefit analysis must be conducted in every instance.

For a lot of women with ADHD and ADD, 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 lead to depression and feelings of isolation. A decrease in medication could also affect the ability to drive safely and to perform work-related tasks which are essential aspects of normal life for people with ADHD.

She suggests that women who aren't sure whether to take the medication or stop it due to their pregnancy should educate family members, coworkers and acquaintances about the condition, the impact on daily functioning and the benefits of keeping the current treatment. It will also help a woman feel supported in her decision. It is important to remember that certain medications are able to be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the medication could be passed on to the baby.

Birth Defects and Risk of

As the use and misuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases as does the concern about the potential effects of these drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Researchers utilized two massive data sets to study over 4.3 million pregnant women and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.

The researchers of the study did not discover any connection between early medication usage and other congenital anomalies such as facial deformities or club feet. The results are in the same vein as previous studies that have shown a small, but significant increase in cardiac malformations for women who began taking ADHD medication before the time of pregnancy. The risk was higher in the latter half of pregnancy, as many women are forced to stop taking their ADHD medication.

Women who were taking ADHD medication during the first trimester were more likely to need a caesarean and also have an insufficient Apgar after delivery and have a baby that needed help breathing after birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who did not have any other medical issues that could have contributed to the findings.

The researchers hope their study will help inform the clinical decisions of physicians who see pregnant women. They suggest that although the discussion of risks and benefits is important however, the decision to stop or keep treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, even though stopping the medication is a possibility to think about, it isn't recommended because of the high incidence of depression and other mental problems among women who can prescribe medication for adhd are pregnant or have recently given birth. 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

It can be a stressful experience to become a mom. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The majority of stimulant medications are absorbed through breast milk in low amounts, therefore the risk to nursing infant is very low. However, the frequency of exposure to medication by the newborn can vary depending on dosage, how often it is taken and the time of day it is administered. In addition, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not yet fully understood.

Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. This is a complicated decision for the patient, who must balance the benefits of continuing her medication against the potential dangers to the fetus. As long as more information is available, doctors may ask pregnant patients whether they have any background of ADHD or if they plan to take medication in the perinatal stage.

A increasing number of studies have proven that the majority of women are able to safely continue taking their adhd medications for adults medication during pregnancy and breastfeeding. In the end, more and more patients are choosing to do so and, after consulting with their doctor, they have found that the benefits of maintaining their current medication far outweigh any risks.

Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non prescription adhd medication for adults-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of indicators of deterioration, and, if necessary modifications to the medication regimen.