This Week's Most Popular Stories About ADHD Medication Pregnancy
This Week's Most Popular Stories About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data regarding how exposure over time may affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the advantages of using them against the risks to the fetus. Doctors don't have enough data to provide clear recommendations, but can provide information on the 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 during early pregnancy did not have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a massive population-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was accurate and to eliminate any bias.
The research conducted by the researchers was not without its limitations. In particular, they were unable to separate the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult for researchers to establish whether the few associations observed between the exposed groups were due to medication use, or if they were affected by the presence of comorbidities. Researchers also did not examine the long-term effects for the offspring.
The study showed that infants whose mothers took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a child with an low Apgar score (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages can be offset by greater benefits to both mother and baby from continuing treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them develop coping skills that may reduce the effects of her disorder on her daily life and relationships.
Interactions with Medication
Doctors are increasingly faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made in the absence of solid and reliable evidence either way, so physicians have to weigh their experience, the experiences of other doctors, and what the research suggests about the subject and their best judgment for each patient.
Particularly, the subject of potential risks to the baby can be tricky. The research that has been conducted on this topic is based on observations instead of controlled studies and the results are conflicting. Most studies focus on live births, which can underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study discussed in the journal club addresses these limitations by analyzing information on deceased and live births.
Conclusion Some studies have shown an association between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. The majority of studies show that there is a neutral, or slight negative impact. Therefore an accurate risk-benefit analysis must be conducted in every instance.
It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. 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 loneliness. A decrease in medication could affect the ability to drive safely and complete work-related tasks, which are crucial aspects of everyday life for people with ADHD.
She suggests women who are adhd medication unsure about whether to continue or stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. It can also help a woman feel confident about her decision. Certain medications can pass through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be passed on to her infant.
Risk of Birth Defects
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns over the impact that these drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.
The researchers of the study could not discover any connection between early medication usage and other congenital anomalies, like facial deformities, or club feet. The results are in line with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the time of pregnancy. This risk increased during the latter part of pregnancy, when many women begin to discontinue their ADHD medications.
Women who took ADHD medication in the first trimester were more likely need a caesarean and also have an insufficient Apgar after delivery and had a baby that required breathing assistance when they were born. The authors of the study were not able to remove bias in selection since they limited their study to women with no other medical conditions that might have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of doctors who treat pregnant women. They recommend that, while discussing the benefits and risks is important however, the decision to stop or maintain treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also warn that, while stopping the medication is an alternative, it is not a recommended practice because of the high incidence of depression and other mental health problems in women who are pregnant or who are recently post-partum. Additionally, research suggests that women who stop taking their medications will have a harder adjustment to life without them once the baby is born.
Nursing
The responsibilities of being a new mom can be overwhelming. Women with ADHD who have to deal with their symptoms while attending doctor appointments and making preparations for the arrival of a child and adjusting to new household routines may face a lot of challenges. As such, many women choose to continue taking their ADHD medications throughout pregnancy.
The risk to a breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk at low levels. The rate of exposure to medication can vary depending upon the dosage and frequency of administration as well as time of day. In addition, various medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't fully understood.
Because of the lack of research, some doctors might be tempted to stop taking stimulant drugs during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the possible risks to the foetus. In the meantime, until more information is available, GPs may ask pregnant patients whether they have any history of ADHD or if they plan to take medication in the perinatal stage.
A increasing number of studies have revealed that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. As a result, more and more patients choose to do so, and after consulting with their doctor, they have found that the benefits of keeping their current medication far outweigh any potential risks.
Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and build strategies for coping. This should involve an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, and monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regime.