Undisputed Proof You Need ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these drugs could affect the fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are needed.

Risk/Benefit Analysis

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

A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers conducted a large sample-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to ensure that the classification was correct and to reduce any bias.

The study conducted by the researchers was not without limitations. In particular, they were unable to separate the effects of the medication from the effects of the disorder at hand. This makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to the use of medications or if they were confounded by comorbidities. In addition the researchers did not examine the long-term outcomes of offspring.

The study showed that infants whose mother took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases did not seem to be influenced by the type of medication that was used during pregnancy.

The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both the mother and child from continued treatment for the woman's condition. Physicians should talk to their patients about this issue and as much as possible, assist them improve coping skills which can lessen the impact of her disorder in her daily life and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to maintain treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of clear and authoritative evidence either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what the research suggests about the subject and their own judgments for each patient.

The issue of risk to infants is extremely difficult. Many studies on this issue are based on observations rather than controlled research, and their findings are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study discussed in this journal club addresses these limitations by analyzing data on live and deceased births.

The conclusion: While some studies have found an association between ADHD medications and the risk of certain birth defects, others have found no such relationship and the majority of studies demonstrate a neutral or slight negative effect. As a result, a careful risk/benefit analysis must be done in each situation.

It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In fact, in an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness, and family conflict for those suffering from the disorder. A loss of medication may also impact the ability to drive safely and to perform work-related tasks which are essential aspects of everyday life for those suffering from ADHD.

She suggests that women who are unsure about whether to keep or discontinue medication due to their pregnancy, consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. It will also help a woman feel more confident in her decision. Certain medications can pass through the placenta. If a woman decides to not take her ADHD medication while breastfeeding, it is crucial to be aware that the drug may be transferred to her infant.

Risk of Birth Defects

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns over the impact that these drugs might have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers utilized two massive data sets to study more than 4.3 million pregnant women and determine whether stimulant medications increased birth defects. Although the risk overall remains low, the scientists discovered that the first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects, like ventriculo-septal defects (VSD).

The researchers of the study found no association between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are consistent with previous studies showing an increase, but not significant, in the risk of heart malformations among women who began taking ADHD medications before pregnancy. This risk increased in the latter half of pregnancy, when a lot of women begin to discontinue their medication.

Women who took ADHD medication during the first trimester were more likely to require a caesarean delivery or have an insufficient Apgar after birth and have a baby who needed breathing assistance at birth. However, the authors of the study were not able to eliminate selection bias by restricting the study to women who did not have any other medical issues that could be a contributing factor to these findings.

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

The authors also warn that while discontinuing the medications is an option, it isn't an option that is recommended due to the high prevalence of depression and other mental health issues among women who are pregnant or who are recently postpartum. Further, research shows that women who stop taking their medication will have a difficult adjustment to life without them after the baby is born.

Nursing

It can be a stressful experience to become a mother. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments as well as making preparations for the arrival of a baby and adapting to new routines in the home may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs pass through breast milk in low amounts, so the risk for breastfeeding infant is minimal. The rate of medication exposure will vary based on the dosage, frequency of administration and the time of the day. In addition, various medications enter the baby’s system through the gastrointestinal tract or through breast milk. The impact on the health of a newborn is not fully comprehended.

Some doctors may stop taking stimulant medications during a woman's pregnancy due to the lack of research. It is a difficult decision for the woman, who must weigh the benefits of her medication against the risk to the fetus. Until more information becomes available, doctors can inquire about pregnant patients whether they have any background of ADHD or if they are planning to take medication during the perinatal period.

A growing number of studies have shown that the majority of women are able to safely continue taking their ADHD medication during pregnancy and breastfeeding. This has led to an increasing number of patients are choosing to do so and, after consulting with their doctor, they have discovered that the benefits of continuing their current medication exceed any risk.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms.  add medication adults  should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. 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, if necessary, adjustments to the medication regimen.