The History Of ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these drugs can affect the fetus.

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

Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the foetus. Physicians don't have the data needed to make unequivocal recommendations but they can provide information about benefits and risks that can assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large sample-based case control study to compare the incidence of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to limit the chance of bias.

However, the researchers' study was not without its flaws.  add in adults medication , they were unable to distinguish the effects of the medication from the disorder that is underlying. This limitation makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or comorbidities that cause confusion. The researchers did not study the long-term effects for the offspring.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had cut back on their medications prior to or during pregnancy. This increase was due to central nervous system-related disorders and the higher risk of admission did not appear to be affected by the type of stimulant medication was used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a child with an low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit to both mother and child from continued treatment for the woman's disorder. Physicians should discuss this with their patients and, where they are able, assist them in developing strategies for improving their coping skills which can reduce the impact of her disorder on her daily life and relationships.

Interactions with Medication

More and more doctors are faced with the decision of whether to keep treatment or stop as more women are diagnosed with ADHD. Often, these decisions are made in the absence of clear and authoritative evidence regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what the research suggests on the subject as well as their own best judgment for each individual patient.

The issue of possible risks to infants is extremely difficult. A lot of studies on this topic are based on observational evidence instead of controlled research and their findings are often contradictory. In addition, most studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.

The conclusion The conclusion: While some studies have shown an association between ADHD medications and the possibility of certain birth defects, other studies have found no connection and the majority of studies have a neutral or slightly negative effect. Therefore an accurate risk-benefit analysis must be done in each case.

It can be challenging, if not impossible for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of isolation. A loss of medication may also impact the ability to safely drive and to perform work-related tasks which are essential aspects of normal life for people with ADHD.

add in adults medication  suggests that women who are not sure whether to continue taking medication or stop due to pregnancy should educate family members, coworkers and their friends about the condition, its effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also help women feel confident about her decision. It is important to remember that certain medications can pass through the placenta, so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be transferred to the child.

Risk of Birth Defects

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

The researchers of the study didn't find any association between early use of medication and congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.

Women who took ADHD medications in the first trimester of pregnancy were also more likely to undergo a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance at birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have other medical issues that could have contributed to the findings.

Researchers hope that their research will inform physicians when they meet pregnant women. The researchers recommend that while discussing risks and benefits are crucial, the decision on whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her needs.

The authors caution that, even though stopping the medication is an option to look into, it is not advised because of the high incidence of depression and other mental disorders among women who are pregnant or have recently given birth. Further, the research suggests that women who choose to stop taking their medication are more likely to experience difficulties getting used to life without them following the baby's arrival.

Nursing

It can be a challenge to become a mother. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to a new routine. Therefore, many women choose to continue taking their ADHD medications throughout the course of pregnancy.

The risk to nursing infant is low because the majority of stimulant medications passes through breast milk at a low level. However, the amount of medication exposure to the newborn can vary depending on dosage, how often it is administered, and the time of day the medication is administered. Additionally, different medications enter the baby's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not yet fully understood.

Because of the lack of evidence, some doctors may recommend stopping stimulant medication during the course of pregnancy. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the potential risks to the embryo. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal time.

Numerous studies have proven that women can continue taking their ADHD medication safely during pregnancy and breast-feeding. In the end, an increasing number of patients opt to do this, and in consultation with their physician, they have discovered that the benefits of maintaining their current medication outweigh any risks.

It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant women suffering from ADHD recognize their symptoms and the root cause Learn about the available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration and, if needed, adjustments to the medication regime.