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ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. There is a lack of information about how long-term exposure to these drugs can affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the benefits of taking them against the potential risks to the fetus. Physicians do not have the information needed to provide clear recommendations but they can provide information on risks and benefits that help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not face an increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants in the early stages of pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was correct and to eliminate any bias.
However, the study was not without its flaws. In particular, they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This makes it difficult to know whether the small associations observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. Additionally the researchers did not look at the long-term effects of offspring on their parents.
The study found that infants whose mother had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medications during early pregnancies could be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman’s disorder. Physicians should speak with their patients about this issue and as much as possible, assist them develop coping strategies that may reduce the impact of her disorder in her daily functioning and her relationships.
Interactions with Medication
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. These decisions are often made without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors and the research on the topic.
The issue types of Adhd medication possible risks to the infant can be particularly tricky. Many studies on this subject are based on observational evidence instead of controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues by analyzing both data on live and deceased births.
The conclusion The conclusion: While certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have found no such relationship and the majority of studies have a neutral or slight negative effect. In each case it is imperative to conduct a thorough analysis of the risks and benefits must be performed.
It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In a recent article in the 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. In addition, a decrease in medication can affect the ability to perform job-related tasks and drive safely, which are important aspects of daily life for a lot of people with ADHD.
She suggests that women who are unsure whether to take the medication or stop it due to their pregnancy, educate their family members, coworkers and acquaintances about the condition, its effects on daily functioning, and the benefits of keeping the current treatment. It will also help a woman feel supported in her decision. It is also worth noting that some medications can you get adhd medication without a diagnosis pass through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be passed on to the baby.
Birth Defects Risk
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about what impact the medications could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Using two massive data sets, researchers were able to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The researchers of the study found no link between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies that have shown a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean delivery and also have a low Apgar after delivery and had a baby that required help breathing at birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who did not have other medical issues that could be a contributing factor to these findings.
The researchers hope their research will aid in the clinical decisions of doctors who see pregnant women. They suggest that although the discussion of the risks and benefits is crucial but the decision to stop or maintain medication must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also caution that, while stopping the medication is an option, it is not an option that is recommended due to the high incidence of depression and other mental health problems in women who are pregnant or who are recently postpartum. Additionally, research suggests that women who stop taking their medication will have a difficult transitioning to life without them after the baby is born.
Nursing
It can be a challenge to become a mother. Women suffering from intuniv adhd medication can face severe challenges when they have to manage their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to a new routine. This is why many women choose to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed by breast milk in small amounts, therefore the risk for infant who is breastfeeding is low. The rate of exposure to medication will vary based on the dosage the medication is administered, its frequency and the time of day. Additionally, different medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't completely known.
Because of the lack of research, some physicians may be inclined to discontinue stimulant medications during the pregnancy of a woman. This is a difficult decision for the woman who must weigh the advantages of continuing her medication against the risks to the fetus. Until more information is available, GPs should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time.
A growing number of studies have proven that most women can safely continue taking their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are opting to continue their medication. They have found, in consultation with their doctor, that the benefits of keeping their current medication outweigh potential risks.
It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women with adhd medication for adults uk be aware of the symptoms and underlying disorder. They should also be informed about treatment options and strengthen coping mechanisms. This should be a multidisciplinary approach together with obstetricians, GPs and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if needed adjustments to the medication regimen.