Why No One Cares About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs could affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental conditions like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication must weigh the benefits of taking it versus the dangers for the foetus. Physicians don't have the necessary data to provide clear recommendations but they can provide information regarding the risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based case control study to compare the incidence of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to confirm that the classification was accurate and to minimize any bias.
The study of 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. That limitation makes it difficult to determine whether the small associations observed in the groups that were exposed result from medication use or the confounding effect of comorbidities. Researchers also did not look at long-term outcomes for the offspring.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or taken off their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk for admission was not found to be influenced by the stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefits to both the mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, when they are able, assist them in developing strategies to improve their coping abilities that can lessen the effects of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or stop treatment during pregnancy is one that more and more doctors face. Most of the time, these decisions are made without any evidence that is clear and definitive in either case, which means that doctors have to weigh their experience, the experiences of other doctors, and what research says on the topic as well as their best judgment for each individual patient.
In particular, the issue of potential risks to the infant can be difficult. Many of the studies on this issue are based on observations rather than controlled research and their findings are often contradictory. In addition, most studies limit their analysis to live births, which Adhd medication is the best may underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study discussed in this journal club addresses these limitations by looking at data from both live and deceased births.
The conclusion is that while some studies have shown an association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative impact. In each case, a careful analysis of the potential risks and benefits must be performed.
For women suffering from adhd medication uk elvanse who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In fact, in an article recently published in the 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 patients with ADHD. Additionally, the loss of medication may affect the ability to perform jobs and drive safely which are essential aspects of a normal life for a lot of people with adhd medication and pregnancy uk.
She recommends that women who are unsure about whether to keep or stop taking medication because of their pregnancy consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the advantages of staying on the current treatment plan. It can also help women feel supported in her decision. Certain medications can be passed through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could be transferred to the baby.
Birth Defects and Risk of
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about what impact the drugs could have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that although the risk overall is low, the first trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.
The researchers of the study could not discover any link between early use of medication and congenital anomalies like facial deformities or club feet. The results are in line with previous studies that have shown the presence of a small, but significant increase in the risk of heart malformations in women who started taking ADHD medications before the time of pregnancy. This risk increased during the latter part of pregnancy, when a lot of women are forced to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean delivery and also have an insufficient Apgar after birth and have a baby that needed breathing assistance after birth. However, the authors of the study were unable to eliminate selection bias by limiting the study to women who did not have any other medical issues that could have contributed to the findings.
Researchers hope their research will inform physicians when they encounter pregnant women. The researchers advise that, while discussing the risks and benefits are important, the decision on whether to continue or stop medication should be made according to the severity of each woman's ADHD symptoms and her needs.
The authors also warn that while discontinuing the medications is an alternative, it is not an option to consider due to the high prevalence of depression and other mental health issues for women who are expecting or who are recently post-partum. Furthermore, research suggests that women who choose to stop their medications are more likely to have difficulties adjusting to life without them following the baby's arrival.
Nursing
It can be a stressful experience to become a mother. Women who suffer from ADHD who must work through their symptoms while attending physician appointments as well as preparing for the arrival of their child and adjusting to new household routines can experience severe challenges. Therefore, many women elect to continue taking their adhd medication pregnancy medications throughout pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk in low amounts. However, the amount of medication exposure to the newborn can vary depending on the dosage, frequency it is taken and the time of the day the medication is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not fully understood.
Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. It is a difficult decision for the woman, who must weigh the advantages of her medication against the risks to the embryo. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. In response, a growing number of patients are opting to continue their medication. They have discovered after consulting with their doctors that the benefits of retaining their current medication outweigh possible risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before 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 offered to help women with ADHD recognize their symptoms and underlying disorder, learn about available treatment options and strengthen existing strategies for managing. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatry. Counselling for pregnancy should include the discussion of a plan for management for both the mother and child, as well as monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.
