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ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There is a lack of information about how long-term exposure to these medications could affect the foetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental disorders like impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the benefits of taking them against the potential risks to the foetus. The doctors don't have the information to provide clear recommendations however they can provide information about risks and benefits to aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major birth defects that are structural. 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 early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to make sure that the classification was correct and to minimize any bias.

However, the researchers' study was not without its flaws. Most important, they were unable to separate the effects of the medication from those of the disorder at hand. This makes it difficult for researchers to determine whether the small associations observed among the groups exposed were due to medication use or if they were caused by co-morbidities. In addition the study did not study the long-term effects of offspring on their parents.

The study did find that infants whose mothers took ADHD medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication that was used during pregnancy.

Women who took stimulant adhd medication names list medications during pregnancy also had a higher risk of having an emergency caesarean section or having the baby was not scoring well on the Apgar scale (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 small risk of using ADHD medications during early pregnancies may be offset by the greater benefits to both mother and baby of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, help them develop strategies to improve their coping abilities that can lessen the impact of her disorder on her daily functioning and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with adhd medication adults uk. Most of the time, these decisions are taken in the absence of any evidence that is clear and definitive either way, so physicians must weigh what they know, the experiences of other doctors, and what research suggests on the subject, along with their own judgments for each individual patient.

Particularly, the issue of potential risks to the baby can be a challenge. The research on this subject is based on observations rather than controlled studies and a lot of the results are conflicting. Additionally, the majority of studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by looking at data from both live and deceased births.

The conclusion: While certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, others have found no such relationship and the majority of studies show a neutral or even slightly negative effect. In all cases, a careful evaluation of the benefits and risks must be performed.

It isn't easy, but not impossible for women suffering from ADHD to stop taking their medication. In a recent article published in the 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. A decrease in medication could also impact the ability to safely drive and to perform work-related tasks which are essential aspects of daily life for those with ADHD.

She suggests women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. Educating them can also help the woman feel supported in her struggle with her decision. Certain medications can be passed through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the drug could be passed on to her baby.

Risk of Birth Defects

As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the potential adverse effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers used two massive data sets to examine more than 4.3 million pregnant women and determine if stimulant medication use increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.

The authors of the study did not discover any connection between early use of medication and congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies that have shown a small, but significant increase in cardiac malformations for women who started taking adhd medication brands uk medication prior to the time of pregnancy. This risk increased during the latter part of pregnancy when a large number of women decided to stop taking their medication.

Women who were taking ADHD medication in the first trimester were more likely need a caesarean, have a low Apgar after delivery and have a baby who needed help breathing after birth. The authors of the study were not able to remove bias in selection since they limited the study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope their research will aid in the clinical decisions of physicians who see pregnant women. They recommend that, while discussing risks and benefits is important however, the decision to stop or maintain treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors caution that, even though stopping the medication is a possibility to think about, it isn't advised because of the high incidence of depression and other mental disorders in women who are expecting or who have recently given birth. Research has also shown that women who stop taking their medication will have a tough time adjusting to a life without them once the baby is born.

Nursing

It can be a stressful experience to become a mom. Women with ADHD who have to deal with their symptoms while attending doctor appointments, making preparations for the arrival of a child and adapting to new routines in the home are often faced with a number of difficulties. This is why many women decide to continue taking their ADHD medication throughout the pregnancy.

The risk for nursing infant is low because the majority of stimulant medications is absorbed through breast milk at low levels. The amount of exposure to medications can vary depending upon the dosage the medication is administered, its frequency and time of day. Additionally, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The impact on the health of a newborn isn't fully understood.

Because of the lack of research, some physicians may recommend stopping adhd medication adults stimulant drugs during a woman's pregnancy. It is a difficult decision for the woman, who must weigh the benefits of her medication against the risks to the fetus. Until more information becomes available, GPs may inquire about pregnant patients if they have a background of ADHD or if they are planning to take medication during the perinatal phase.

Numerous studies have proven that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, a growing number of patients are choosing to do so. They have concluded, in consultation with their doctor, that the benefits of retaining their current medication far outweigh any possible risks.

Women who suffer from Adhd medication pregnancy who plan to breastfeed should seek the advice of an expert psychiatrist prior to 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 medication treatment for adhd adults-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder and learn about treatment options and strengthen existing strategies for managing. This should be a multidisciplinary effort including obstetricians, GPs and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration, and the need for adjustments to the medication regimen.