ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice 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 drugs may affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental disorders like impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.

Risk/Benefit Analysis

Pregnant women who use ADHD medications used for adhd need to balance the advantages of using them against the risks to the fetus. Doctors don't have enough data to give clear advice however they can a general practitioner prescribe adhd medication provide information on risks and benefits to aid pregnant women in making an informed decision.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not face a significantly increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a massive population-based case control study to assess the frequency of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to make sure that the classification was accurate and to eliminate any bias.

However, the researchers' study was not without its flaws. Researchers were unable to, in the first place to distinguish the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the small associations observed among the groups that were exposed to the use of medications or if they were affected by co-morbidities. The researchers also did not study long-term outcomes for the offspring.

The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or stopped their medications before or during pregnancy. This increase was due to central nervous system-related disorders and the higher risk of admission was not found to be influenced by which stimulant medications were used during pregnancy.

Women who took stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby with low Apgar score (less than 7). These increases did not appear to be influenced by the type of medication that was used during pregnancy.

The researchers suggest that the risk of a small amount 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. Doctors should discuss with their patients about this issue and try to help them develop coping skills that may reduce the impact of her disorder in her daily functioning and her relationships.

Interactions with Medication

More and more doctors are confronted with the dilemma of whether to keep treatment or stop it during pregnancy as more women are diagnosed with Adhd medication pregnancy. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other physicians and the research that has been conducted on the subject.

Particularly, the subject of potential risks for the baby can be a challenge. The research on this subject is based on observations instead of controlled studies and the results are in conflict. Most studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study presented in this journal club addresses these limitations by examining data on both live and deceased births.

The conclusion The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have found no connection, and most studies demonstrate a neutral or slight negative effect. In every case it is imperative to conduct a thorough analysis of the benefits and risks should be conducted.

For many women with ADHD, the decision to stop taking medication is 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 lead to depression and feelings of isolation. Furthermore, a loss of medication may affect the ability to do work-related tasks and safely drive which are essential aspects of daily life for many people suffering from ADHD.

She recommends women who are uncertain about whether or not to stop medication in light of their pregnancy should consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. Educating them can also aid in ensuring that the woman feels supported when she is struggling with her decision. It is also worth noting that some drugs can be absorbed through the placenta therefore, if a patient decides to stop taking her buy adhd medication online medication during pregnancy and breastfeeding, she should be aware 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, so do concerns about the effects that the medications could have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers used two massive data sets to examine more than 4.3 million pregnancy and determine if stimulant medication use increased birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.

The researchers of the study found no link between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in agreement with previous studies that have shown an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. The risk was higher in the later part of pregnancy, when a lot of women are forced to stop taking their medication.

Women who took ADHD medication during the first trimester were more likely to require a caesarean birth, have a low Apgar after birth and have a baby that needed breathing assistance when they were born. The researchers of the study could not eliminate bias due to selection because they restricted the study to women with no other medical conditions that could have contributed to the findings.

The researchers hope their study will aid in the clinical decisions of doctors who encounter pregnant women. They advise that while the discussion of risks and benefits is important but the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also caution that even though stopping the medication is an option, it is not an option that is recommended due to the high incidence of depression and other mental health problems among women who are pregnant or postpartum. Further, the research suggests that women who decide to stop taking their medication are more likely to have difficulties getting used to life without them following the baby's arrival.

Nursing

The responsibilities that come with being a new mother can be overwhelming. Women with ADHD who have to manage their symptoms while attending physician appointments, getting ready for the arrival of a child and adjusting to new household routines can experience severe challenges. As such, many women decide to continue taking their ADHD medication throughout the pregnancy.

The majority of stimulant drugs pass through breast milk in very small amounts, so the risk to the nursing infant is very low. The rate of exposure to medication will differ based on dosage, frequency of administration and time of day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't yet fully understood.

Because of the lack of research, some physicians may be inclined to discontinue stimulant medication during the course of pregnancy. This is a difficult decision for the woman, who must weigh the advantages of continuing her medication against the risks to the embryo. As long as there is no more information, GPs 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 to take their ADHD medication without risk during pregnancy and breast-feeding. In the end, more and more patients choose to do so and, after consulting with their doctor, they have discovered that the benefits of keeping their current medication exceed any risk.

Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD recognize their symptoms and the underlying disorder, learn about available treatments and to reinforce existing strategies for managing. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if necessary modifications to the medication regime.