ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There aren't enough data regarding how exposure over time may affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians don't have the data needed to give clear guidelines, but they can provide information on the risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. simply click the up coming post , pediatric cardiologists and other experts examined the cases to make sure that the classification was correct and to minimize any bias.
The research conducted by the researchers was not without limitations. The researchers were unable to, in the first place to differentiate the effects caused by the medication from the disorder. That limitation makes it difficult to know whether the small differences observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. In addition, the researchers did not examine long-term offspring outcomes.
The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases did not appear to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies may be offset by the greater benefits for mother and baby from continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is a question that doctors are having to have to face. Often, these decisions are made without solid and reliable evidence regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what the research says on the topic, along with their best judgment for each individual patient.
Particularly, the subject of potential risks to the baby can be tricky. Many studies on this issue are based on observational data rather than controlled research, and their findings are often contradictory. The majority of studies focus on live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both information on deceased and live births.
The conclusion is that while some studies have shown an association between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link, and most studies demonstrate a neutral or slight negative effect. In the end an accurate risk-benefit analysis must be done in each case.
For a lot of women with ADHD and ADD, the decision to stop taking medication is difficult, if not impossible. In a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation and family conflict for these patients. Furthermore, a loss of medication may affect the ability to do jobs and drive safely, which are important aspects of daily life for many people with ADHD.
She suggests that women who are not sure whether to continue taking medication or discontinue it due to pregnancy should 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. In addition, educating them can help the woman feel supported as she struggles with her decision. Some medications can pass through the placenta. If a woman decides to not take her ADHD medication while pregnant and breastfeeding, it is crucial 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, so do concerns over the impact that these drugs might have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. With two massive data sets researchers were able to look at more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).
The researchers behind the study found no association between early medication use and congenital abnormalities like facial clefting, or club foot. The results are in the same vein as previous studies which showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of pregnancy. 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 during the first trimester were more likely need a caesarean or have a low Apgar after delivery and had a baby that required help breathing after birth. The authors of the study could not eliminate selection bias because they restricted the study to women without 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. The researchers advise that, while discussing the risks and benefits are important, the decision regarding whether or not to stop medication should be made according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors warn that, although stopping the medication is a possibility to consider, it is not recommended because of the high incidence of depression and other mental disorders among women who are pregnant or who have recently given birth. Research has also shown that women who stop taking their medications will have a harder time adjusting to a life without them after the baby is born.
Nursing
The responsibilities of being a new mother can be overwhelming. Women with ADHD are often faced with a number of difficulties when they must deal with their symptoms, go to 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 the course of pregnancy.
click the following webpage of stimulant medicines are absorbed by breast milk in low quantities, so the risk to the nursing infant is very low. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of day. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isn't fully known.
Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. This is a complicated decision for the patient, who must weigh the benefits of continuing her medication with the potential risks to the fetus. As long as more information is available, GPs may ask pregnant patients whether they have any background of ADHD or if they intend to take medication in the perinatal period.
A growing number of studies have shown that the majority of women are able to safely continue taking their ADHD medication during pregnancy and breastfeeding. In the end, more and more patients opt to do this and in consultation with their physician, they have found that the benefits of maintaining their current medication outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also be informed about treatment options and build the coping mechanisms. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, monitoring of indicators of deterioration, and, if needed, adjustments to the medication regimen.