ADHD Medication Pregnancy: 10 Things I'd Like To Have Known Sooner
ADHD Medication Pregnancy: 10 Things I'd Like To Have Known Sooner
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs may affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication should evaluate the benefits of using it against the potential risks for the foetus. Doctors don't have enough data to provide clear recommendations but they can provide information on risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not face a significantly 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 took stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate classification of the cases and to reduce the chance of bias.
The study of the researchers had some limitations. The researchers were unable in the beginning to distinguish the effects of the medication from the disorder. This makes it difficult for researchers to determine if the small differences observed between the exposed groups were due to the use of medication or if they were affected by the presence of comorbidities. Additionally, the researchers did not look at the long-term effects of offspring on their parents.
The study showed 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) as compared to those whose mothers did not take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the higher risk of admission was not found to be affected by the type of stimulant medications were taken during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a child with a low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy.
Researchers suggest that the minor risk of using ADHD medications during early pregnancies can be offset by greater benefits to both baby and mother of continued treatment for the woman's condition. Physicians should talk to their patients about this and, if possible, help them develop coping strategies that could reduce 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. Often, these decisions are made without clear and authoritative evidence in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what the research suggests on the subject as well as their best judgment for each individual patient.
The issue of potential risks to infants is difficult to determine. The research that has been conducted on this topic is based on observations instead of controlled studies and the results are in conflict. The majority of studies limit their analysis to live-births, which could underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these shortcomings by analyzing data on live and deceased births.
Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies click here have shown an unintended, or slight negative effect. In each case an in-depth study of the risks and benefits is required.
For a lot of women with ADHD, the decision to stop taking medication is difficult if not impossible. In a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for those suffering from the disorder. A decrease in medication could also impact the ability to safely drive and perform work-related tasks, which are crucial aspects of everyday life for people with ADHD.
She suggests 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 regimen. In addition, educating them can help the woman feel supported when she is struggling with her decision. Some medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it is important to be aware that the drug could be transferred to the baby.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about the effects that the drugs could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Using two massive data sets, researchers were able to look at more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. While the overall risk remains low, the scientists discovered that the first-trimester exposure to ADHD medicines was associated with an increase in the risk of specific heart defects, like ventriculo-septal defects (VSD).
The researchers of the study didn't discover any link between early medication usage and congenital anomalies like facial deformities or club feet. The results are in line with previous studies that showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to pregnancy. The risk was higher in the latter half of pregnancy, when a lot of women begin to discontinue their medication.
Women who took ADHD medications during the first trimester of their pregnancies were also more likely to experience caesarean section, low Apgar score after delivery and a baby who needed breathing assistance during birth. The researchers of the study were not able to remove bias in selection since they restricted the study to women without other medical conditions that might have contributed to the findings.
The researchers hope their study will serve to inform the clinical decisions of doctors who encounter pregnant women. They suggest that although a discussion of the risks and benefits is crucial, the decision to stop or keep medication must be based on each woman's needs and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is a possibility to look into, it is not recommended due to the high rate depression and other mental problems among women who are pregnant or have recently given birth. Research has also shown that women who stop taking their medication will have a harder adjustment to life without them once the baby is born.
Nursing
The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments as well as making preparations for the arrival of a child and adjusting to new household routines may face a lot of challenges. This is why many women decide to continue taking their ADHD medication throughout the pregnancy.
The risk to breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk in low amounts. However, the amount of exposure to medications by the infant can differ based on dosage, how often it is administered and at what time the medication is administered. In addition, different medications are introduced into the baby's system via the gastrointestinal tract or breast milk. The impact on the health of a newborn is not fully comprehended.
Because of the lack of evidence, some doctors may be inclined to discontinue stimulant medications during the pregnancy of a woman. This is a difficult choice for the patient, who must balance the benefit of continuing her medication against the possible dangers to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time.
A growing number of studies have revealed that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are opting to continue their medication. They have discovered through consultation with their doctors, that the benefits of retaining their current medication far outweigh any potential risks.
It's important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD understand their symptoms and the root cause Learn about the available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatry. Counselling for pregnancy should include discussion of a management plan for both the mother and child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.