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ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs could affect the foetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Women who are expecting and taking adhd inattentive type medication medication should evaluate the benefits of using it against the possible dangers for the foetus. The doctors don't have the information to provide clear recommendations but they can provide information about risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers used a vast population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy, and those who can prescribe adhd medication did not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure correct case classification and to limit the possibility of bias.

However, the researchers' study had its limitations. The researchers were not able, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult to know whether the limited associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. The researchers also did not study long-term outcomes for offspring.

The study showed that infants whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.

Women who took stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a child with low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication taken during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies can be offset by greater benefits for mother and baby from continuing treatment for the woman’s disorder. Physicians should talk to their patients about this issue and, if possible, help them develop coping skills that can lessen the impact of her disorder in her daily life and relationships.

Interactions with Medication

As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether or not to end treatment during pregnancy is a question that more and more physicians confront. These decisions are frequently made without clear and authoritative evidence. Instead, physicians must consider their own expertise in conjunction with the experiences of other doctors, and the research on the topic.

The issue of potential risks to the infant can be particularly tricky. The research on this issue is based on observation rather than controlled studies, and the results are in conflict. most effective adhd medication for adults studies restrict their analysis to live births, which can underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these issues by analyzing both data on live and deceased births.

The conclusion The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship, and most studies show a neutral or even slightly negative impact. In every case an in-depth study of the benefits and risks must be performed.

It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In fact, in an article published in 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 those suffering from the disorder. Furthermore, a loss of medication may affect the ability to do work-related tasks and safely drive which are essential aspects of a normal life for many people suffering from ADHD.

She recommends women who are uncertain about whether to keep or stop medication in light of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. It can also help the woman feel supported in her struggle with her decision. Some medications can pass through the placenta. If a patient decides not to take her concerta adhd medication medication while breastfeeding, it is crucial to be aware that the medication may be transferred to her baby.

Risk of Birth Defects

As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Using two massive data sets researchers were able to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects like ventriculo-septal defects (VSD).

The researchers behind the study found no association between early medication use and other congenital anomalies, such as facial clefting or club foot. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. The risk was higher during the latter part of pregnancy, when many women decide to stop taking their medication.

Women who took ADHD medication during the first trimester were more likely require a caesarean delivery or have a low Apgar after birth and had a baby that required help breathing at birth. The authors of the study could not remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.

Researchers hope that their research will help doctors when they meet pregnant women. They suggest that although a discussion of risks and benefits is important however, the decision to stop or keep medication should be based on each woman's needs and the severity of her adhd medication pregnancy symptoms.

The authors also advise that while discontinuing the medications is an option, it is not an option that is recommended due to the high rate of depression and other mental health issues for women who are expecting or post-partum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to experience difficulties getting used to life without them after the birth of their baby.

Nursing

The responsibilities that come with being a new mother can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they have to manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk in low amounts. The rate of medication exposure will differ based on dosage, frequency of administration and the time of day. In addition, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn is not completely understood.

Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the lack of research. This is a complicated decision for the patient, who must weigh the benefits of continuing her medication against the potential dangers to the fetus. Until more information becomes available, doctors may ask pregnant patients whether they have any background of ADHD or if they are planning to take medication during the perinatal phase.

A increasing number of studies have revealed that most women can safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are opting to do so. They have discovered after consulting with their doctors that the benefits of retaining their current medication outweigh potential risks.

Women who suffer from ADHD who are planning to nurse should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant people with ADHD understand their symptoms and the root cause and learn about treatment options and reinforce existing strategies for coping. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatry. Pregnancy counseling should consist of a 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.