5 Laws That Anyone Working In ADHD Medication Pregnancy Should Be Aware Of
ADHD Medication During Pregnancy and BreastfeedingWomen suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these drugs could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the benefits of using them against the risks to the fetus. Doctors don't have enough data to make unambiguous recommendations but they can provide information on the risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who took stimulants during early pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias.
The study conducted by the researchers was not without limitations. Researchers were unable, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult to determine whether the small associations observed in the exposed groups result from medication use or comorbidities that cause confusion. In addition the researchers did not examine the long-term effects of offspring on their parents.
The study did show that infants whose mothers took ADHD medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean birth or having a baby with a low Apgar score (less than 7). These increases did not appear to be affected 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 could be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or stop treatment during pregnancy is a question that doctors are having to confront. Most of the time, these decisions are made without clear and authoritative evidence either way, so physicians must weigh their knowledge about their experiences, the experiences of other doctors, and what the research suggests on the subject as well as their own best judgment for each individual patient.
The issue of potential risks to infants is particularly tricky. Many of the studies on this issue are based on observations rather than controlled research, and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that can lead to abortions or terminations of pregnancy. The study discussed in this journal club addresses these issues by analyzing data on live and deceased births.
The conclusion The conclusion: While some studies have found an association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative effect. In every case, a careful analysis of the potential risks and benefits is required.
It isn't easy, but not impossible for women suffering from ADHD click here to stop taking their medication. In fact, in an article recently published in the 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 these patients. A loss of medication may affect the ability to drive safely and complete work-related tasks, which are crucial aspects of normal life for those with ADHD.
She recommends women who are uncertain about whether or not to discontinue medication due to their pregnancy should consider the possibility of educating friends, family members, and coworkers on the condition, its impact on daily life, and the advantages of continuing the current treatment plan. It can also help women feel supported in her decision. It is important to note that some medications are able to pass through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug could be passed on to the baby.
Risk of Birth Defects
As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing, so does concern about the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Utilizing two huge data sets, researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Researchers discovered that although the overall risk 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 did not discover any link between the use of early medications and other congenital anomalies, such as facial deformities or club feet. The results are in agreement 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 pregnancy. The risk grew in the latter half of pregnancy, when many women are forced to stop taking their ADHD medication.
Women who took ADHD medications during the first trimester of pregnancy were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby who needed breathing assistance at birth. The authors of the study could not eliminate bias due to selection because 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 study will inform physicians when they see pregnant women. The researchers advise that while discussing benefits and risks are crucial, the decision regarding whether or not to stop medication should be based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also advise that even though stopping the medication is an option, it is not an option to consider due to the high rate of depression and other mental health problems among women who are pregnant or post-partum. Additionally, the research suggests that women who decide to stop their medications are more likely to have a difficult time getting used to life without them following the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small amounts, so the risk to the nursing infant is very low. However, the frequency of exposure to medications by the infant can differ based on the dosage, frequency it is administered, and at what time the medication is administered. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The impact on the health of a newborn isn't completely known.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant drugs during the pregnancy of a woman. This is a difficult choice for the patient, who must balance the benefits of continuing her medication against the possible dangers to the foetus. In the meantime, until more information is available, doctors may inquire about pregnant patients whether they have an history of ADHD or if they plan to take medication during the perinatal stage.
Numerous studies have proven that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. In response, a rising number of patients are choosing to do this. They have found after consulting with their doctors, that the benefits of keeping their current medication outweigh any possible risks.
It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their doctor, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant women suffering from ADHD understand their symptoms and the root cause Learn about the available treatment options and reinforce existing strategies for coping. This should include an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, monitoring of signs of deterioration and, if necessary adjustments to the medication regime.