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ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There are few data regarding how exposure over the counter adhd medication for adults time may affect a fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders such as hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who take ADHD medications need to balance the benefits of taking them against the potential risks to the fetus. Physicians don't have the data to make unambiguous recommendations, but can provide information on risks and benefits to help pregnant women make an informed decision.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Clinical geneticists and pediatric cardiologists examined the cases to ensure correct case classification and to minimize the possibility of bias.

However, the researchers' study had its limitations. Researchers were unable, in the first place to distinguish the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of Medications Used For Adhd or caused by comorbidities. Additionally, the researchers did not study the long-term outcomes of offspring.

The study did show that babies whose mothers had taken ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or cut back on their medications prior to 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 took stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy.

Researchers suggest that the small risks associated with the use different adhd medications medication during pregnancies in the early stages can be offset by greater benefits for mother and baby from continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them improve coping skills which could reduce the effects of her disorder on her daily life and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of solid and reliable evidence regardless, so doctors have to weigh their experience, the experiences of other doctors, and what research suggests on the subject as well as their best medication for adhd combined type judgment for each patient.

The issue of risk for infants can be particularly tricky. A lot of studies on this issue are based on observational evidence rather than controlled research, and their conclusions are often contradictory. The majority of studies restrict their analysis to live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.

The conclusion The conclusion: While certain studies have demonstrated an association between ADHD medications and the possibility of certain birth defects, others have found no connection and the majority of studies demonstrate a neutral or slightly negative impact. Therefore, a careful risk/benefit assessment is required in every case.

It can be difficult, if not impossible for women with ADHD to stop taking their medication. In a recent article 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 isolation. A decrease in medication could also affect the ability to safely drive and perform work-related tasks, which are essential aspects of everyday life for people with ADHD.

She suggests that women who aren't sure whether to continue taking the medication or discontinue it due to pregnancy educate family members, colleagues, and their friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment. It can also help a woman feel supported in her decision. It is important to note 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 must be aware that traces of the drug can be transferred to the infant.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medicines was associated with an increase in the risk of certain heart defects such as ventriculo-septal defect (VSD).

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

Women who took ADHD medication in the first trimester were more likely to need a caesarean or have an insufficient Apgar after delivery and had a baby that required breathing assistance at birth. The authors of the study were unable to eliminate bias due to selection because they restricted the study to women without other medical conditions that could have contributed to the findings.

The researchers hope that their research will serve to inform the clinical decisions of physicians who encounter pregnant women. The researchers advise that, while discussing benefits and risks are important, the choice regarding whether or not to stop taking medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.

The authors also caution that while discontinuing the medications is an alternative, it is not a recommended practice because of the high incidence of depression and other mental health problems for women who are expecting or post-partum. Additionally, research suggests that women who stop taking their medications will have a difficult transitioning to life without them once the baby is born.

Nursing

The responsibilities of a new mom can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments, getting ready for the arrival of their child and adapting to new routines in the home can experience severe challenges. As such, many women choose to continue taking their ADHD medication throughout the pregnancy.

The risk to breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk in low estrogen and adhd medication amounts. The rate of exposure to medication will vary based on the dosage and frequency of administration as well as time of day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn isn't well known.

Because of the lack of evidence, some doctors may recommend stopping stimulant drugs during the course of pregnancy. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risks to the foetus. In the meantime, until more information is available, GPs may ask pregnant patients whether they have an history of ADHD or if they intend to take medication during the perinatal stage.

A increasing number of studies have proven that women can continue their ADHD medication during pregnancy and while breastfeeding. This has led to an increasing number of patients opt to do this and, in consultation with their doctor they have discovered that the benefits of continuing their current medication outweigh any 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 prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be informed about treatment options and reinforce strategies for coping. This should be a multidisciplinary process including obstetricians, GPs, 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 regime.