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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 isn't much information on how long-term exposure to these medications may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication 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 research is needed.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to weigh the benefits of taking it versus the risks for the baby. Doctors don't have enough data to provide clear recommendations but they can provide information on the risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who took stimulants during early pregnancy and those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate classification of the cases and to reduce the chance of bias.
The study conducted by the researchers was not without limitations. The researchers were unable to, in the first place, to separate the effects triggered by the medication from the disorder. That limitation makes it difficult to know whether the small differences observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. In addition, the researchers did not study the long-term outcomes of offspring.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or stopped their medications before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies could be offset by the greater benefits to both mother and baby of continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies to improve their coping abilities which can reduce the effects of her disorder on her daily life and relationships.
Interactions with Medication
Doctors are increasingly confronted with the dilemma of whether to keep treatment or stop during pregnancy as more women are diagnosed with best adhd medication for adults with anxiety and depression. These decisions are usually made without clear and authoritative evidence. Instead, physicians must weigh their own knowledge, the experience of other doctors and the research that has been conducted on the subject.
The issue of risk to the infant can a general practitioner prescribe adhd medication be extremely difficult. The research on this subject is based on observation rather than controlled studies and many of the findings are conflicting. Most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these shortcomings by examining data on both live and deceased births.
Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies show an unintended, or slightly negative, impact. In the end an accurate risk-benefit analysis is required in every instance.
It isn't easy, but not impossible, for women suffering from ADHD to stop taking their Medication For Adhd And Bipolar (Trade-Britanica.Trade). In fact, 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 loneliness 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 daily life for those with ADHD.
She recommends that women who are unsure about whether to continue or discontinue medication due to their pregnancy should consider educating family members, friends, and coworkers on the condition, its impact on daily functioning, and the benefits of keeping the current treatment plan. Educating them can also make the woman feel more comfortable as she struggles with her decision. It is important to remember that some drugs can pass through the placenta therefore, if a patient decides to discontinue her adhd medication names list medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be passed on to the baby.
Risk of Birth Defects
As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increased risk of specific heart defects, like ventriculo-septal defects (VSD).
The authors of the study did not discover any link between early medication usage and other congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that have shown an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication before pregnancy. This risk increased in the latter half of pregnancy, when a lot of women begin to discontinue their ADHD medication.
Women who were taking ADHD medication during the first trimester were more likely to require a caesarean delivery and also have a low Apgar after delivery, and have a baby that needed help breathing when they were born. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who did not have any other medical conditions that could have contributed to these findings.
The researchers hope that their research will serve to inform the clinical decisions of physicians who encounter pregnant women. They recommend that, while discussing the risks and benefits is crucial but the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is an option to look into, it is not advised due to the high rate depression and mental health issues for women who are pregnant or have recently given birth. Further, research shows that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
The responsibilities of a new mother can be overwhelming. Women with ADHD who must work through their symptoms while attending physician appointments and preparing for the arrival of a child and adjusting to new household routines can experience severe challenges. Therefore, many women decide to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines are absorbed by breast milk in very small quantities, so the risk to the infant who is breastfeeding is low. However, the amount of exposure to medication by the infant can differ based on dosage, how often it is administered and the time of the day it is administered. Additionally, different medications are introduced into the baby's system via the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not completely comprehended.
Because of the lack of evidence, some doctors prescribing adhd medication may recommend stopping stimulant medications during the course of pregnancy. It is a difficult decision for the woman who must weigh the benefits of taking her medication as well as the potential risks to the embryo. In the meantime, until more information is available, GPs should ask all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.
Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and while breast-feeding. In the end, many patients opt to do this and in consultation with their physician, they have found that the benefits of maintaining their current medication exceed any risk.
Women with ADHD who are planning to nurse should seek advice from an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also learn about treatment options and strengthen coping mechanisms. This should be a multidisciplinary process including obstetricians, GPs, and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.