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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications may affect the fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders such as hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.

Risk/Benefit Analysis

Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the foetus. The doctors don't have the information to provide clear recommendations however they can provide information about risks and benefits to aid pregnant women in making an informed decision.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at higher risk of fetal malformations, or structural birth defects. The researchers used a large population-based study of case-control to assess the risk of major structural birth defects in babies born to mothers who took stimulants during early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias.

The study conducted by the researchers was not without its limitations. In particular, they were not able to differentiate the effects of the medication from those of the disorder that is underlying. This makes it difficult for researchers to establish whether the small differences observed between the groups that were exposed to the use of medications, or if they were affected by comorbidities. The researchers did not look at long-term outcomes for offspring.

The study revealed that infants whose mothers took adhd medications for adults medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU) in comparison to mothers who did not take any medication during pregnancy or had stopped taking their medication before or during pregnancy. This was due to central nervous system-related disorders, and the increased risk of admission did not appear to be influenced by which stimulant medications were used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a baby with low Apgar score (less than 7). These risks did not appear to be influenced by the kind of medication used during pregnancy.

Researchers suggest that the minor risks associated with the use ADHD medications in early pregnancies may be offset by the greater benefits to both mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies for improving their coping skills that may minimize the impact of her disorder on her daily life and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are often made without clear and reliable evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors and the research on the subject.

The issue of possible risks to infants is difficult to determine. Many studies on this subject are based on observations instead of controlled research and their conclusions are often contradictory. Most studies limit their analysis to live births, which may underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study discussed in this journal club addresses these shortcomings by analyzing data on live and deceased births.

Conclusion A few studies have shown an association between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies show a neutral, or even somewhat negative, effect. In the end, a careful risk/benefit analysis is required in every instance.

It isn't easy, but not impossible, for women with ADHD to stop taking their medication. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of isolation. A decrease in medication could also affect the ability to safely drive and to perform work-related tasks which are essential aspects of everyday life for those suffering from ADHD.

She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy educate family members, coworkers and their friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment regimen. It can also help a woman feel supported in her decision. It is also worth noting that certain medications can pass through the placenta, therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug can be transferred to the infant.

Birth Defects Risk

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about the effects that the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. With two massive data sets, researchers were able to examine more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).

The researchers behind 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 agreement with previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to pregnancy. This risk increased during the latter part of pregnancy, as many women decide to stop taking their ADHD medication.

Women who took ADHD medication during the first trimester were more likely need a caesarean or have a low Apgar after delivery, and have a baby who needed help breathing when they were born. However, the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could have contributed to these findings.

Researchers hope their research will provide doctors with information when they meet pregnant women. The researchers advise that while discussing the risks and benefits are important, the choice about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her requirements.

The authors also advise that while discontinuing the medications is an option, it is not an option to consider due to the high rate of depression and other mental health issues among women who are pregnant or post-partum. Further, the research suggests that women who choose to stop taking their medications are more likely to have difficulties adjusting to life without them after the birth of their baby.

Nursing

It can a doctor prescribe adhd medication be overwhelming to become a mother. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments and making preparations for the arrival of their child and adapting to new routines in the home can experience severe challenges. This is why many women choose to continue taking their ADHD 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 frequency of medication exposure to the newborn may differ based on the dosage, frequency it is taken and the time of the day the medication is administered. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isn't well known.

Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. It's a difficult choice for the mother, who must weigh the advantages of taking her medication as well as the risk to the embryo. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal period.

A growing number of studies have shown that women can doctors prescribe adhd medication a doctor prescribe adhd medication (additional resources) continue to take their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are opting to continue their medication. They have discovered after consulting with their doctor, that the benefits of keeping their current medication outweigh any potential risks.

Women who suffer from adhd medication weight loss uk who are planning to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand their symptoms and underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should include a multidisciplinary approach, which adhd medication is the best includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include discussion of a treatment plan for can a Doctor prescribe adhd medication the mother as well as the child, and monitoring for signs of deterioration, and, if needed, adjustments to the medication regime.