ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how long-term exposure may affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required.

Risk/Benefit Analysis

Pregnant women who take ADHD medications need to balance the advantages of using them against the risks to the fetus. Doctors don't have enough data to make unambiguous recommendations however they can provide information on risks and benefits to assist pregnant women to make an informed decision.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face a significantly increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large population-based study of case-control to determine the prevalence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, as well as those who had not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was correct and to minimize any bias.

The study conducted by the researchers had some limitations. The researchers were not able, in the first place to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine if the small differences observed between the groups exposed were due to the use of medication, or if they were caused by comorbidities. Additionally, the researchers did not look at the long-term effects of offspring on their parents.

The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or stopped their medications before or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.

Women who took stimulant adhd no medication medications during pregnancy also had a higher chance of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medication during pregnancies in the early stages could be offset by the more beneficial outcomes for both baby and mother of continued treatment for the woman's disorder. Physicians should discuss this with their patients and, when possible, help them develop strategies for improving their coping skills that can lessen the impact of her disorder on her daily life and relationships.

Medication Interactions

Doctors are increasingly faced with the decision of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of clear and authoritative evidence either way, so physicians must weigh their knowledge from their own experiences, those of other doctors, and what the research suggests on the subject as well as their own best judgment for each individual patient.

Particularly, the issue of possible risks to the infant can be difficult. A lot of studies on this topic are based on observations rather than controlled research and their findings are often contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these issues by analyzing data on live and deceased births.

The conclusion is that 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 such relationship and the majority of studies demonstrate a neutral or slightly negative effect. In every case an in-depth evaluation of the risks and benefits should be conducted.

For women suffering from ADHD and ADD, the decision to stop medication can be difficult, if not impossible. In fact, in an article published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping adhd Medication Pregnancy medication during pregnancy can cause depression, feelings of isolation, and family conflict for these patients. In addition, a decrease in medication can affect the ability to complete work-related tasks and safely drive that are crucial aspects of a normal life for many people suffering from ADHD.

She recommends that women who are unsure about whether to continue or discontinue medication due to their pregnancy should consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the advantages of continuing the current treatment plan. It will also help a woman feel supported in her decision. Certain medications can be passed through the placenta. If a woman decides to stop taking her ADHD medication while 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 and misuse of liquid adhd medication uk medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the potential effects of these drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Using two massive data sets researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect.

The researchers of the study did not find any association between early use of medication and other congenital anomalies, like facial deformities, or club feet. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before the birth of their child. This risk increased during the latter stages of pregnancy when a large number of women stopped taking their medication.

Women who were taking adhd medication intuniv medication in the first trimester were more likely to need a caesarean or have an insufficient Apgar after birth and had a baby that required help breathing at birth. However the researchers of the study were not able to eliminate selection bias by limiting the study to women who didn't have other medical issues that could have contributed to these findings.

The researchers hope their study will aid in the clinical decisions of doctors who see pregnant women. They suggest that although a discussion of the benefits and risks is important, the decision to stop or maintain treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, although stopping the medication is an option to look into, it is not advised because of the high incidence of depression and mental health issues in women who are expecting or who have recently given birth. Further, research shows that women who stop taking their medications will have a difficult time adjusting to a life without them once the baby is born.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments as well as preparing for the arrival of a child and adapting to new routines in the home may face a lot of challenges. Many women opt to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs are absorbed by breast milk in small amounts, so the risk to nursing infant is very low. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and the time of the day. Additionally, different drugs enter the infant's system via the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn isn't completely known.

Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the advantages of continuing her medication against the risk to the fetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal period.

Many studies have shown that women can continue taking their ADHD medication in a safe manner during pregnancy and while breast-feeding. As a result, an increasing number of patients choose to do so and, in consultation with their physician, they have discovered that the benefits of continuing their current medication outweigh any potential risks.

Women who suffer from ADHD who are planning to breastfeed should seek the advice of 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 is also required to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be educated about treatment options and reinforce the coping mechanisms. This should be an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counselling should include discussion of a management plan for both the mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.