ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There aren't enough data on how exposure to ADHD for a long time could affect the foetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological conditions like hearing or vision impairment seizures, 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 taking them against potential risks to the foetus. Physicians do not have the information needed to make unequivocal recommendations however they can you get adhd medication without a diagnosis provide information about the risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers conducted a massive population-based case control study to assess the frequency of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure correct case classification and to limit the chance of bias.

The study conducted by the researchers had some limitations. Most important, they were not able to differentiate the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult for researchers to determine whether the few associations observed between the exposed groups were due to the use of medications or if they were caused by comorbidities. Additionally, the researchers did not examine the long-term outcomes of offspring.

The study showed that infants whose mother took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to those whose mothers did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or one whose baby scored low on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefit to both mother and child of continued treatment for the woman's condition. Doctors should discuss with their patients about this issue and as much as possible, assist them develop coping strategies that can lessen the effects of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is a question that more and more physicians face. These decisions are usually taken without clear and authoritative evidence. Instead, physicians must take into account their own experience, the experience of other physicians and the research that has been conducted on the subject.

Particularly, the subject of potential risks for the baby can be tricky. A lot of studies on this topic are based on observations instead of controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by looking at data from both live and deceased births.

Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies show a neutral, or even slight negative impact. Therefore, a careful risk/benefit assessment must be done in each situation.

For many women with ADHD, the decision to stop taking medication is difficult if not impossible. In a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping safest adhd medication for adults medications during pregnancy can increase depression and feelings of being isolated. In addition, a decrease in medication may affect the ability to complete work-related tasks and safely drive that are crucial aspects of a normal life for many people with ADHD.

She suggests women who are uncertain about whether to continue or stop uk medication for adhd in light of their pregnancy should consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of staying on the current treatment plan. It can also help women feel confident about her decision. It is important to remember that some drugs can pass through the placenta, therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug can be transferred to the child.

Risk of Birth Defects

As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (Adhd medication making it worse), increases as does the concern about the potential effects of these drugs on foetuses. 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 more than 4.3 million pregnant women and determine if the use of stimulant medications caused birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication use was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The authors of the study could not discover any connection between early use of medication and other congenital anomalies, like facial deformities or club feet. The results are consistent with previous studies showing an increase, but not significant, in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk was higher in the latter half of pregnancy, when a lot of women decide to stop taking their medication.

Women who took ADHD medication in the first trimester of their pregnancies were also more likely to have caesarean section, low Apgar score after delivery and a baby who required breathing assistance during birth. The authors of the study were not able to eliminate bias due to selection because they limited their study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope that their research will serve to inform the clinical decisions of doctors who treat pregnant women. The researchers advise that while discussing the risks and benefits are important, the choice on whether to continue or stop medication should be made according to the severity of each woman's ADHD symptoms and her requirements.

The authors warn that, while stopping the medication is an option to consider, it is not advised because of the high incidence of depression and other mental disorders for women who are pregnant or who have recently given birth. Additionally, research suggests that women who stop taking their medication will have a tough adjustment to life without them once the baby is born.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to a new routine. As such, many women elect to continue taking their ADHD medications throughout pregnancy.

The risk to nursing infant is low because the majority of stimulant medications passes through breast milk in low amounts. The rate of exposure to medication will differ based on dosage and frequency of administration as well as the time of day. Additionally, different types of adhd medication medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isn't well known.

Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the absence of research. It's a difficult choice for the mother, who must weigh the advantages of taking her medication as well as the risks to the fetus. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether they are taking or planning to take medication during the perinatal period.

Numerous studies have proven that women can continue to take their ADHD medication safely while breastfeeding and during pregnancy. In response, an increasing number of patients are choosing to continue their medication. They have concluded through consultation with their doctor that the benefits of retaining their current medication outweigh possible risks.

It's important for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD understand their symptoms and underlying disorder, learn about available treatment options and strengthen existing strategies for managing. This should involve a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.