ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how long-term exposure may affect the foetus.

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

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication should consider the benefits of taking it against the potential risks for the foetus. The doctors don't have the information to make unambiguous recommendations, but can provide information about risks and benefits to help pregnant women make an informed decision.

A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers used a large sample-based case control study to assess the frequency of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was accurate and to reduce any bias.

The study of the researchers was not without limitations. The most important issue was that they were not able to differentiate the effects of the medication from the effects of the disorder that is underlying. That limitation makes it difficult to know whether the limited associations observed in the groups that were exposed are due to the use of medication or the confounding effect of comorbidities. Additionally the study did not examine the long-term effects of offspring on their parents.

The study did find that babies whose mothers had taken adhd Medication pregnancy medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a baby with a low Apgar score (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 minor risks posed by the use of ADHD medications in early pregnancies can be offset by more beneficial outcomes for both mother and baby of continuing treatment for the woman's disorder. Doctors should discuss with their patients about this issue and, if possible, help them develop coping skills that can lessen the impact of her disorder in her daily life and relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or stop treatment during pregnancy is one that doctors are having to confront. Often, these decisions are made without any evidence that is clear and definitive in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests on the subject as well as their best judgment for each individual patient.

In particular, the issue of potential risks for the infant can be difficult. The research that has been conducted on this topic is based on observations rather than controlled studies and the results are contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects that can lead to terminations or abortions of pregnancy. The study presented in this journal club addresses these shortcomings by examining data on both live and deceased births.

Conclusion Some studies have found a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show a neutral, or even slight negative impact. In every case, a careful evaluation of the benefits and risks should be conducted.

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 being isolated. Additionally, the loss of medication can affect the ability to do job-related tasks and drive safely, which are important aspects of a normal life for a lot of people with ADHD.

She suggests that women who are not sure whether to continue taking medication or stop it due to their pregnancy educate family members, coworkers and their friends about the condition, its impact on daily functioning and the benefits of keeping the current treatment regimen. It can also help a woman feel confident about her decision. Certain medications can pass through the placenta. If the patient decides not to take her ADHD medication while breastfeeding, it's important to be aware that the drug could be passed on to her infant.

Risk of Birth Defects

As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so does concern about the potential effects of these drugs on foetuses. 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 over 4.3 million pregnancies and determine whether stimulant medications caused birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with a slightly higher rate of specific heart defects, such as ventriculoseptal defect (VSD).

The researchers of the study found no connection between early use different types of adhd medication medication and congenital abnormalities like facial clefting, or club foot. The findings are in line with previous studies showing an increase, but not significant, in the risk of cardiac malformations in women who started taking concerta adhd medication medications prior to the time of pregnancy. This risk increased in the later part of pregnancy, when many women decide to stop taking their medication.

Women who took ADHD medication in the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who required help breathing at birth. The authors of the study could not eliminate selection bias because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.

Researchers hope that their study will help doctors when they meet pregnant women. The researchers advise that while discussing benefits and risks are important, the choice regarding whether or not to stop taking medication should be based on the severity of each woman's ADHD symptoms and her requirements.

The authors also advise that even though stopping the medication is an option, it is not an option to consider due to the high rate of depression and other mental health problems for women who are expecting or recently postpartum. Additionally, research suggests that women who stop taking their medications will have a tough transitioning to life without them after the baby is born.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments as well as preparing for the arrival of a child and getting used to new routines at home can experience severe challenges. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant medications are absorbed through breast milk in small amounts, therefore the risk for infant who is breastfeeding is low. The rate of medication exposure will differ based on dosage, frequency of administration and the time of day. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn is not well understood.

Due to the absence of research, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. This is a difficult decision for the patient, who must balance the benefits of keeping her medication with the potential risks to the embryo. As long as more information is available, GPs may ask pregnant patients whether they have an history of ADHD or if they intend to take medication during the perinatal phase.

A growing number of studies have proven that the majority of women are able to safely continue taking their adhd medications for adults medication while they are pregnant and nursing. In response, a rising number of patients are choosing to continue their medication. They have found through consultation with their doctor that the benefits of continuing their current medication outweigh any possible risks.

Women with adhd stimulant medication who plan to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help pregnant people with ADHD be aware of their symptoms and the underlying disorder and learn about treatment options and reinforce existing strategies for coping. This should be a multidisciplinary approach including obstetricians, GPs and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, monitoring of indicators of deterioration, and, if needed adjustments to the medication regimen.