Enriqueta Hyam

ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or continue ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There are few data on how long-term exposure may affect a foetus.

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

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication need to weigh the benefits of taking it against the possible risks for the fetus. Physicians do not have the necessary data to provide clear recommendations however they can provide information on the risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD best medication for ocd and adhd in early pregnancy were not at higher risk of fetal malformations or structural birth defects. The researchers used a large population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists examined the cases to ensure correct classification of the cases and to reduce the possibility of bias.

However, the study was not without its flaws. Most important, they were unable to distinguish the effects of the medication from the underlying disorder. This makes it difficult for researchers to determine whether the few associations observed between the groups that were exposed to medication use or affected by co-morbidities. Additionally the study did not look at the long-term effects of offspring on their parents.

The study did show that infants whose mothers took ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher 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 section or having a baby born with low Apgar score (less than 7). These increases did not appear to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the minor risk of using 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 they are able, assist them in developing strategies for improving their coping skills that may minimize the effects of her disorder on her daily functioning and relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of clear and authoritative evidence regardless, so doctors have to weigh their experience from their own experiences, those of other doctors, and what medication is prescribed for adhd research says on the topic, along with their own best adhd Medication for Adults uk judgment for each individual patient.

Particularly, the subject of potential risks for the infant can be difficult. The research on this subject is based on observation instead of controlled studies and a lot of the results are in conflict. Most studies limit their analysis to live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study discussed in this journal club addresses these issues by examining data on both live and deceased births.

The conclusion The conclusion: 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 have a neutral or slightly negative effect. In each case it is imperative to conduct a thorough study of the potential risks and benefits should be conducted.

For women suffering from ADHD and ADD, the decision to stop taking medication is difficult, if not impossible. In an article published in 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 patients with ADHD. In addition, a decrease in medication may affect the ability to perform work-related tasks and safely drive, which are important aspects of a normal life for many people suffering from ADHD.

She suggests that women who are unsure whether to take the medication or stop it due to their pregnancy should educate family members, coworkers and friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment regimen. Educating them can also help the woman feel supported when she is struggling with her decision. It is important to remember that some medications are able to pass through the placenta, therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be transferred to the child.

Birth Defects Risk

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns over the impact that these drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. With two massive data sets researchers were able analyze more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.

The authors of the study found no connection between early medication use and other congenital anomalies, like facial clefting, or club foot. The findings are in line with previous studies that have shown a small but significant increase in the risk of heart malformations among women who began taking ADHD medications prior to the time of pregnancy. This risk increased in the latter half of pregnancy, when many women begin to discontinue their ADHD medications.

Women who took ADHD medications during the first trimester of pregnancy were also more likely to undergo a caesarean section, a low Apgar score following delivery, and a baby who prescribes medication for adhd needed help breathing at birth. The researchers of the study could not eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings.

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

The authors also advise that even though stopping the medication is an option, it is not an option to consider due to the high incidence of depression and other mental health problems for women who are expecting or recently postpartum. Additionally, the research suggests that women who choose to stop their medications are more likely to experience difficulties adjusting to life without them following the birth of their baby.

Nursing

The responsibilities of a new mother can be overwhelming. Women with ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the rate of exposure to medications by the newborn may differ based on dosage, frequency it is administered and the time of the day the medication is administered. In addition, various 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 completely understood.

Due to the absence of research, some physicians may recommend stopping stimulant medications during the pregnancy of a woman. It's a difficult choice for the woman who must weigh the advantages of taking her medication as well as the risks to the embryo. As long as more information is available, doctors may inquire about pregnant patients if they have an background of ADHD or if they plan to take medication during the perinatal stage.

A increasing number of studies have shown that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are opting to do this. They have concluded, in consultation with their doctor, that the benefits of keeping their current medication far outweigh any potential risks.

Women with ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons for 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 be educated about treatment options and build the coping mechanisms. This should be a multidisciplinary effort with the GPs, obstetricians, and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both the mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.