ADHD Medication Pregnancy: The Good The Bad And The Ugly
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ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how does adhd medication work for adults long-term exposure to these medications can affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological conditions like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to evaluate the benefits of using it against the possible risks to the fetus. Doctors don't have the information needed to provide clear recommendations however they can provide information about the risks and benefits to assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a greater risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case control study to compare the incidence of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to make sure that the classification was correct and to eliminate any bias.
The research conducted by the researchers was not without limitations. The researchers were not able in the beginning to differentiate the effects caused by the medication from the disorder. This makes it difficult to know whether the small associations observed in the exposed groups result from medication use or comorbidities that cause confusion. Additionally the study did not study long-term offspring outcomes.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at slightly more 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. The reason for this was central nervous system-related disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having a caesarean section or one whose baby scored low on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy.
Researchers suggest that the small risk of using ADHD medications in 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 discuss this with their patients and, where they are able, assist them in developing strategies to improve coping skills which can reduce the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
Many doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with adhd and medication. These decisions are frequently made without clear and reliable evidence. Instead, doctors have to consider their own expertise, the experience of other physicians and the research that has been conducted on the subject.
Particularly, the issue of possible risks to the baby can be tricky. The research on this subject is based on observation rather than controlled studies and the results are conflicting. Furthermore, most studies restrict their analysis to live births, which could underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing data on live and deceased births.
The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no such relationship and the majority of studies show a neutral or even slightly negative impact. Therefore, a careful risk/benefit assessment is required in every situation.
For many 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 loneliness, and family conflict for patients with ADHD. A loss of medication may also affect the ability to safely drive and perform work-related tasks, which are vital aspects of normal life for those with adhd medication without prescribing (simply click the following page).
She suggests that women who are unsure whether to continue taking medication or stop due to pregnancy should educate family members, colleagues, and acquaintances about the condition, the impact on daily functioning and the benefits of keeping the current treatment plan. It can also help women feel more confident in her decision. It is also worth noting that certain medications can pass through the placenta, so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the medication could be passed on to the baby.
Birth Defects and Risk of
As the use of safest adhd medication for adults medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. With two massive data sets, researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.
The authors of the study found no association between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in line with previous studies showing a small but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk grew during the latter part of pregnancy, as many women begin to discontinue their ADHD medication.
Women who were taking ADHD medication in the first trimester were more likely to need a caesarean or have a low Apgar after birth and have a baby who needed help breathing when they were born. The researchers of the study were unable to eliminate bias due to selection because they restricted the study to women with no other medical conditions that might have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of physicians who see pregnant women. They advise that while a discussion of risks and benefits is important, the decision to stop or continue medication should be based on the woman's requirements and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is an option to think about, it isn't advised due to the high rate depression and other mental disorders for women who are pregnant or have recently given birth. Research has also shown that women who stop taking their medication will have a difficult adjustment to life without them once the baby is born.
Nursing
The responsibilities of being a new mother can be overwhelming. Women with ADHD who have to deal with their symptoms while attending doctor appointments as well as getting ready for the arrival of their child and adapting to new routines in the home are often faced with a number of difficulties. Many women choose to continue taking their generic adhd medications medication during 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 may differ based on dosage, frequency it is taken and at what time it is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn isn't fully understood.
Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the woman who must weigh the benefits of continuing her medication against the risks to the foetus. In the meantime, until more information is available, doctors may ask pregnant patients if they have an background of ADHD or if they plan to take medication in the perinatal stage.
A increasing number of studies have shown that women can continue their ADHD medication during pregnancy and while breastfeeding. As a result, many patients opt to do this and, in consultation with their doctor they have found that the benefits of keeping their current medication outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help women with ADHD recognize their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.
