ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how long-term exposure may affect the foetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication For adhd and anxiety in adults during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high-quality studies are required.

Risk/Benefit Analysis

Pregnant women who use ADHD medications must weigh the benefits of using them against the risks to the fetus. Doctors don't have the information needed to give clear guidelines however they can provide information regarding benefits and risks that can aid 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 have an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large population-based study of case-control 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. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to make sure that the classification was accurate and to reduce any bias.

However, the study had its limitations. The researchers were unable in the beginning, to separate the effects caused by the medication from the disorder. This limitation makes it difficult to know whether the small associations observed in the exposed groups are due to the use of medication or comorbidities that cause confusion. The researchers did not examine the long-term effects for the offspring.

The study did show that infants whose mothers took ADHD medications 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 had cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication 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 born with a low Apgar score (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages can be offset by greater benefits to both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, if they are able, assist them in developing strategies for improving their coping skills that can lessen the effects of her disorder on her daily functioning and relationships.

Interactions with Medication

As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether or not to stop treatment during pregnancy is a question that more and more doctors confront. These decisions are often made without clear and authoritative evidence. Instead, doctors must take into account their own experience in conjunction with the experiences of other doctors, and the research on the topic.

In particular, the issue of possible risks to the baby can be tricky. The research on this subject is based on observation rather than controlled studies and many of the findings are contradictory. most common adhd medications studies restrict their analysis to live births, which may underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study presented 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 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 the majority of studies demonstrate a neutral or slightly negative effect. In each case, a careful evaluation of the potential risks and benefits must be performed.

It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In an article published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for these patients. Furthermore, a loss of medication may affect the ability to do jobs and drive safely which are essential aspects of daily life for many people suffering from ADHD.

She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy, educate their family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the advantages of staying on the current treatment plan. It can also help a woman feel confident about her decision. It is also worth noting that some medications are able to be absorbed through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the infant.

Birth Defects and Risk of

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about what impact the medications could have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Researchers used two huge data sets to examine over 4.3 million pregnant women and determine if stimulant medication use caused birth defects. Although the risk overall remains low, the scientists did find that first-trimester exposure to ADHD medicines was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).

The researchers behind the study found no association between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in line with previous studies revealing the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking ADHD medications before the time of pregnancy. This risk increased during the latter half of pregnancy, when a lot of women began to stop taking their medication.

Women who were taking ADHD medication during the first trimester were more likely to need a caesarean and also have a low Apgar after delivery, and had a baby that required breathing assistance when they were born. The researchers of the study could not eliminate selection bias because they restricted the study to women without other medical conditions that could have contributed to the findings.

The researchers hope their research will help inform the clinical decisions of physicians who treat pregnant women. The researchers advise that while discussing the risks and benefits are crucial, the decision regarding whether or not to stop medication should be made based on the severity of each woman's ADHD symptoms and her needs.

The authors also caution that even though stopping the medication is an option, it isn't a recommended practice because of the high incidence of depression and other mental health problems in women who are pregnant or post-partum. Further, research shows that women who stop taking their medications will have a harder transitioning to life without them after the baby is born.

Nursing

The responsibilities that come with being a new mother can be overwhelming. Women with ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.

The risk for breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. However, the amount of exposure to medication by the newborn can vary depending on the dosage, frequency it is administered and at what time the medication is administered. In addition, different medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The impact on the health of a newborn isn't fully comprehended.

Due to the absence of research, some doctors may be inclined to discontinue stimulant medications during a woman's pregnancy. It's a difficult choice for the woman who must weigh the advantages of taking her medication as well as the potential risks to the embryo. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time.

A increasing number of studies have revealed that women can continue to take their ADHD medication during pregnancy and breastfeeding. As a result, more and more patients choose to do so, and after consulting with their doctor, they have found that the benefits of keeping their current medication exceed any risk.

It's important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and reinforce strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration and, if necessary, adjustments to the medication regime.