The No. One Question That Everyone Working In ADHD Medication Pregnancy Should Be Able To Answer
The No. One Question That Everyone Working In ADHD Medication Pregnancy Should Be Able To Answer
Blog Article
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 breast-feeding. There is a lack of information about how long-term exposure to these drugs could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological disorders like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication should evaluate the benefits of using it versus the risks to the fetus. Doctors don't have the necessary data to give clear guidelines, but they can provide information about the risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure accurate case classification and to limit the chance of bias.
However, the study was not without its flaws. The researchers were unable to, in the first place to distinguish the effects caused by the medication from the disorder. That limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to medication use or comorbidities that cause confusion. Additionally, the researchers did not examine long-term offspring outcomes.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not affected by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this and, if possible, help them develop coping skills that could reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of clear and authoritative evidence either way, so physicians have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests on the subject as well as their own judgments for each patient.
Particularly, the subject of possible risks to the baby can be tricky. The research that has been conducted on this topic is based on observation rather than controlled studies and many of the findings are conflicting. Additionally, the majority of studies limit their analysis to live births, which may underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link, and most studies show a neutral or even slight negative effect. In each case an in-depth analysis of the risks and benefits must be performed.
For a lot of women with ADHD, the decision to stop taking medication can be difficult, if not impossible. In a recent article 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 being isolated. Furthermore, a loss of medication may affect the ability to complete job-related tasks and drive safely which are essential aspects of daily life for many people suffering from ADHD.
She suggests that women who are not sure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers, and their friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment plan. It can also help a woman feel supported in her decision. Some medications can pass 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 drug could be passed on to her baby.
Birth Defects and Risk of
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the medications could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine if stimulant medication use increased the risk of birth defects. While the overall risk remains low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study found no link between the use of early medications and congenital abnormalities like facial clefting, or club foot. The findings are in line with previous studies revealing an increase, but not significant, in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. This risk increased during the latter part of pregnancy, when a lot of women stopped taking their medication.
Women who took ADHD medication during the first trimester were more likely require a caesarean birth, have a low Apgar after birth and have a baby who needed help breathing when they were born. The authors of the study were not able to eliminate bias due to selection because they limited the study to women without other medical conditions that could have contributed to the findings.
The researchers hope that their research will help inform the clinical decisions of doctors who encounter pregnant women. The researchers recommend that, while discussing the risks and benefits are important, the decision on whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her requirements.
The authors caution 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 recently gave birth. Additionally, research suggests that women who stop taking their medications will have a difficult transitioning to life without them once the baby is born.
Nursing
It can be a stressful experience to become a mother. Women with ADHD who have to manage their symptoms while attending physician appointments, getting ready for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. Therefore, many women decide to continue taking their ADHD medications throughout pregnancy.
The risk to nursing infant is low because the majority of stimulant medication passes through breast milk at a low level. However, the frequency of medication exposure to the newborn can vary depending on dosage, frequency it is taken and the time of the day it is administered. Additionally, different medications enter the baby’s system via the gastrointestinal tract or through breast milk. The effect on a newborn's health is not fully comprehended.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack of research. It is a difficult decision for the mother, who must weigh the benefits of her medication against the risk to the embryo. As long as more information is available, doctors may inquire about pregnant patients if they have an history of ADHD or if they intend to take medication in the perinatal period.
Numerous studies have demonstrated that women can continue taking their ADHD medication in a safe manner while breastfeeding and during pregnancy. This has led to many patients are choosing to do so and, in consultation with their physician, they have found that the benefits of continuing their current website medication exceed any risk.
Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be informed about treatment options and build coping mechanisms. This should be a multidisciplinary approach including obstetricians, GPs, and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if needed modifications to the medication regimen.