ADHD Medication Pregnancy: 10 Things I d Like To Have Known Earlier
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 breast-feeding. Little data exists about how long-term exposure to these medications could affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental conditions like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have enough data to make unambiguous recommendations, but can provide information on the risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry found that women who used generic adhd medications (Federatedjournals blog entry) medications during their early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers used a vast population-based study of case-control to assess the risk of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was correct and to minimize any bias.
The study conducted by the researchers was not without its limitations. The most important issue was that they were not able to differentiate the effects of the medication from the disorder that is underlying. This limitation makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medications or affected by co-morbidities. The researchers also did not study the long-term effects for the offspring.
The study found that infants whose mother had taken ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU), compared to those whose mothers did not use any medication during pregnancy or quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the increased risk of admission was not found to be influenced by which stimulant medication was used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a child with an low Apgar score (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit for both mother and child from continued treatment for the woman's disorder. Physicians should discuss this with their patients and, if possible, assist them in developing strategies to improve coping skills that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to continue or end treatment during pregnancy is a question that more and more doctors face. Most of the time, these decisions are taken in the absence of solid and reliable evidence either way, so physicians have to weigh their experience, the experiences of other doctors, and what the research says on the topic and their best judgment for each individual patient.
In particular, the issue of possible risks to the baby can be tricky. The research on this subject is based on observations rather than controlled studies, and many of the findings are in conflict. Most studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study presented in this journal club addresses these shortcomings by analyzing data on live and deceased births.
Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies have shown a neutral, or even slightly negative, effect. Therefore, a careful risk/benefit assessment must be done in each situation.
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 cause depression and feelings of loneliness. A loss of medication may also impact the ability to safely drive and perform work-related tasks, which are crucial aspects of everyday life for people with ADHD.
She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and on the advantages of staying on the current treatment regimen. Educating them can also help the woman feel supported in her struggle with her decision. It is important to remember that certain drugs can pass through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be transferred to the child.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns over the impact that these medications could have on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Using 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. While the overall risk remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).
The authors of the study didn't discover any link between early medication usage and other congenital anomalies, such as facial deformities or club feet. The results are in line with previous studies which adhd medication is best for me quiz showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of pregnancy. This risk increased during the latter part of pregnancy, when many women begin to discontinue their ADHD medication.
Women who took ADHD medications in the first trimester of pregnancy were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance at birth. However the authors of the study were unable to eliminate selection bias by restricting the study to women who did not have any other medical conditions that could have contributed to these findings.
The researchers hope their study will aid in the clinical decisions of doctors who encounter pregnant women. The researchers recommend that while discussing benefits and risks are crucial, the decision regarding whether or not to stop medication should be made based on the severity of each woman's adhd focus medication symptoms and her requirements.
The authors also caution that, while stopping the medication is an alternative, 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 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 of being a new mother can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments, prepare for the birth of a baby and adjust to new adhd medication routines. Therefore, many women elect to continue taking their ADHD medication throughout the pregnancy.
The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. However, the frequency of exposure to medications by the infant can differ based on dosage, how often it is administered and the time of the day the medication is administered. Additionally, different medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not well understood.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack of research. It's a difficult choice for the mother, who must weigh the benefits of her medication against the potential risks to the foetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal period.
A growing number of studies have revealed that women can continue their ADHD medication during pregnancy and breastfeeding. In response, a rising number of patients are opting to continue their medication. They have concluded after consulting with their doctors that the benefits of keeping their current medication outweigh risk.
Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also learn about treatment options and strengthen coping mechanisms. This should be a multidisciplinary process including obstetricians, GPs and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration, and, if necessary modifications to the medication regimen.
