ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how exposure to ADHD for a long time could affect the pregnant fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.

Risk/Benefit Analysis

Women who are pregnant and taking adhd medication making it worse medication should consider the benefits of taking it against the possible risks for the baby. Physicians do not have the data needed to give clear guidelines but they can provide information on the risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry found that women who were taking adhd and anxiety medication medications during early pregnancy did not face an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large population-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to ensure that the classification was accurate and to eliminate any bias.

However, the researchers' study was not without its flaws. The researchers were not able, in the first place to differentiate the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine whether the small differences observed between the groups exposed were due to medication use or if they were confounded by the presence of comorbidities. In addition, the researchers did not study the long-term effects of offspring on their parents.

The study showed that infants whose mothers had taken ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy, or had quit taking the medication 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 medications used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a baby with low estrogen and adhd medication Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medication during pregnancies in the early stages may be offset by the greater benefits for mother and baby from continuing treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them develop coping skills that could reduce the effects of her disorder on her daily functioning and her relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or stop treatment during pregnancy is a question that doctors are having to face. Most of the time, these decisions are made without solid and reliable evidence in either case, which means that doctors have to weigh their experience, the experiences of other doctors, and what research says on the topic, along with their own best judgment for each patient.

In particular, the issue of potential risks to the baby can be tricky. The research that has been conducted on this topic is based on observation rather than controlled studies and many of the findings are conflicting. The majority of studies limit their analysis to live births, which may underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study discussed in this journal club addresses these shortcomings by analyzing data on live and deceased births.

The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no connection, and most studies have a neutral or slightly negative effect. As a result an accurate risk-benefit analysis must be conducted in every situation.

It can be challenging, if not impossible, for women with ADHD to stop taking their medication. In a recent piece published in 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 loneliness. In addition, a decrease in medication may affect the ability to complete job-related tasks and drive safely which are essential aspects of a normal life for a lot of people with mild adhd medication (check out this one from Wikimapia).

She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the benefits of continuing the current treatment. Educating them can also make the woman feel more comfortable as she struggles with her decision. It is important to remember that some medications can be absorbed through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be passed on to the baby.

Birth Defects Risk

As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (adhd medication for women) increases, so does concern about the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Researchers found that while the overall risk is low, the first trimester adhd medication and pregnancy uk exposure to medication was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects.

The researchers of the study found no association between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in agreement with previous studies that showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication before the birth of their child. This risk increased in the latter half of pregnancy, as many women begin to discontinue their ADHD medications.

Women who took ADHD medication during the first trimester were more likely need a caesarean or have an insufficient Apgar after delivery and had a baby that required breathing assistance when they were born. The researchers of the study were unable to eliminate selection bias because they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.

Researchers hope their research will help doctors when they see pregnant women. The researchers suggest that, while discussing the risks and benefits are important, the decision on whether to continue or stop taking medication should be according to the severity of each woman's ADHD symptoms and her needs.

The authors also warn that while discontinuing the medications is an option, it is not an option to consider due to the high incidence of depression and other mental health problems among women who are pregnant or postpartum. Additionally, the research suggests that women who choose to stop taking their medication are more likely to experience a difficult time adapting to life without them after the baby's arrival.

Nursing

The responsibilities of a new mom can be overwhelming. Women with ADHD may face a lot of challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.

The majority of stimulant medications are absorbed through breast milk in very small quantities, so the risk for breastfeeding infant is minimal. However, the rate of exposure to medication by the newborn can vary depending on dosage, frequency it is administered, and the time of the day it is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract or through breast milk. The impact on the health of a newborn is not fully known.

Due to the absence of research, some doctors may be inclined to discontinue stimulant medications during a woman's pregnancy. This is a difficult decision for the mother, who must weigh the advantages of taking her medication as well as the risk to the foetus. In the meantime, until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal period.

Numerous studies have demonstrated that women can continue to take their ADHD medication without risk while breastfeeding and during pregnancy. As a result, many patients choose to do so, and in consultation with their physician, they have discovered that the benefits of keeping their current medication exceed any risk.

Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant people with ADHD be aware of their symptoms and underlying disorder Learn about the available treatment options and reinforce existing strategies for coping. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration, and, if needed modifications to the medication regimen.