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. Little data exists about how long-term exposure to these drugs may affect the fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the potential risks for the foetus. Physicians don't have the information needed to provide clear recommendations however they can provide information about risks and benefits that help pregnant women make informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants in early pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was correct and to reduce any bias.

The study of the researchers was not without its limitations. The researchers were unable, in the first place, to separate the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small associations observed among the exposed groups were due to medication use or if they were caused by the presence of comorbidities. The researchers also did not examine long-term outcomes for offspring.

The study revealed that babies whose mothers had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not take any medication during pregnancy or stopped taking their medication before or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who used stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.

Researchers suggest that the minor risks associated with the use ADHD medication during pregnancies in the early stages may be offset by the greater benefits to both mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, when possible, help them develop strategies for improving their coping skills that can lessen the impact 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 dilemma of whether to continue or discontinue treatment during pregnancy is a question that more and more physicians face. These decisions are usually made without clear and authoritative evidence. Instead, physicians must consider their own expertise and experience, as well as the experiences of other doctors, and the research that has been conducted on the subject.

The issue of possible risks to infants is extremely difficult. The research that has been conducted on this topic is based on observation instead of controlled studies and the results are conflicting. Most studies limit their analysis to live births, which may underestimate the teratogenic impact that can lead to abortions or terminations of pregnancy. The study presented in this journal club addresses these shortcomings by analyzing data on live and deceased births.

The conclusion: While certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, other studies have found no connection, and most common adhd medications studies demonstrate a neutral or slightly negative impact. As a result, a careful risk/benefit analysis must be done in each instance.

For a lot of women with ADHD and ADD, the decision to stop medication is difficult, if not impossible. In fact, 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. A loss of medication may also affect the ability to safely drive and perform work-related tasks, which are vital aspects of everyday life for those suffering from ADHD.

She recommends that women who are unsure about whether or not to discontinue medication due to their pregnancy consider educating family members, friends, and coworkers on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. It can also help women feel more confident in her decision. Certain medications can pass through the placenta. If the patient decides to not take her adhd medication uk elvanse medication while breastfeeding, it is important to be aware that the drug may be transferred to her baby.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Researchers utilized two massive data sets to study more than 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers found that while the risk overall is low estrogen and adhd medication, first-trimester ADHD exposure to medication was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.

The authors of the study found no connection between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in line with previous studies that showed a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of pregnancy. This risk increased during the latter part of pregnancy, as many women decide to stop taking their ADHD medication.

Women who took ADHD medication during the first trimester were more likely to need a caesarean and also have a low Apgar after delivery and have a baby that needed help breathing at birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical conditions that could be a contributing factor to these findings.

The researchers hope their research will serve to inform the clinical decisions of physicians who see pregnant women. They advise that while the discussion of risks and benefits is important but the decision to stop or keep medication should be based on each woman's requirements and the severity of her ADHD symptoms.

The authors caution that, even though stopping the medication is a possibility to look into, it is not advised because of the high incidence of depression and other mental problems in women who are expecting or have recently given birth. Further, research shows that women who stop taking their medication will have a difficult time adjusting to a life without them after the baby is born.

Nursing

It can be a stressful experience to become a mom. Women with ADHD may face a lot of challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to new routines. As such, many women choose to continue taking their ADHD medications throughout pregnancy.

The majority of stimulant medications are absorbed through breast milk in small amounts, therefore the risk to nursing infant is very low. The rate of exposure to medication will vary based on the dosage the medication is administered, its frequency and the time of the day. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not fully understood.

Some doctors may stop taking 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 taking her medication as well as the risks to the embryo. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and whether they are taking or planning to take medication during the perinatal time.

Numerous studies have demonstrated that women can continue taking their ADHD medication in a safe manner while breastfeeding and during pregnancy. This has led to many patients are choosing to do so and, after consulting with their doctor, they have discovered that the benefits of keeping their current medication far outweigh any risks.

Women who suffer from adhd medication and pregnancy uk (daoqiao.net) who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary effort with the GPs, obstetricians, and psychiatry. The pregnancy counselling should consist of discussion of a management plan for both mother and child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.