This Week s Most Popular Stories About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from Common Adhd Medications Uk have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data regarding how exposure over time may affect a pregnant fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the foetus. Physicians don't have the data to provide clear recommendations however they can provide information about risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. Researchers used a large sample-based case control study to compare the incidence of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate case classification and to limit the chance of bias.
However, the study was not without its flaws. Most important, they were unable to separate the effects of the medication from those 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 caused by the presence of comorbidities. In addition the researchers did not look at the long-term outcomes of offspring.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.
Researchers suggest that the small risk of using ADHD medications in early pregnancies can be offset by greater benefits for baby and mother of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, if they are able, assist them in developing strategies for improving their coping skills that can lessen the negative impact of her condition on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is one that more and more doctors face. Most of the time, these decisions are made in the absence of solid and reliable evidence in either case, which means that doctors have to weigh their experience, the experiences of other doctors, and what medication is given for adhd research suggests about the subject, along with their own best judgment for each individual patient.
The issue of risk to infants is extremely difficult. The research on this subject is based on observations rather than controlled studies and a lot of the results are in conflict. Additionally, the majority of studies limit their analysis to live births, which may underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these limitations by looking at data from both live and deceased births.
The conclusion: While some studies have found 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 slightly negative impact. As a result, a careful risk/benefit assessment must be conducted in every instance.
It can be challenging, if not impossible, for women with ADHD to stop taking their medication. In fact, in a recent article in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for patients with ADHD. Additionally, the loss of medication for inattentive adhd and anxiety can affect the ability to perform work-related tasks and safely drive, which are important aspects of daily life for many people suffering from ADHD.
She suggests that women who are unsure whether to continue taking medication or stop due to pregnancy educate family members, coworkers and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment. It can also help a woman feel confident about her decision. Certain medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be transferred to the baby.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (inattentive adhd medication) grows as do concerns about what impact the drugs might have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. With two massive data sets, researchers were able to examine more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study didn't find any association between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the birth of their child. This risk increased during the latter stages of pregnancy when a large number of women began to stop taking their medication.
Women who used ADHD medications in the first trimester of their pregnancies were also more likely to undergo a caesarean section, a low Apgar score following delivery, and a baby that required breathing assistance at birth. However the researchers of the study were not able to eliminate bias due to selection by limiting the study to women who did not have any other medical conditions that could be a contributing factor to these findings.
Researchers hope their research will help doctors when they encounter pregnant women. The researchers recommend that, while discussing risks and benefits are important, the choice on whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and her requirements.
The authors also caution that while discontinuing the medications is an option, it is not an option to consider due to the high prevalence of depression and other mental health problems among women who are pregnant or recently post-partum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have difficulties adjusting to life without them after the birth of their baby.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant drugs are absorbed through breast milk in very small quantities, so the risk to infant who is breastfeeding is low. However, the amount of exposure to medications by the newborn may differ based on dosage, how often it is administered and the time of day it is administered. In addition, different medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The effect on a newborn's health is not completely understood.
Because of the lack of research, some doctors may recommend stopping stimulant medications during the course of pregnancy. It's a difficult choice for the woman, who must weigh the advantages of her medication against the potential risks to the foetus. In the meantime, until more information is available, doctors can ask pregnant patients if they have an history of ADHD or if they are planning to take medication during the perinatal period.
A growing number of studies have revealed that the majority of women are able to safely continue taking their ADHD medication while they are pregnant and nursing. In response, an increasing number of patients are opting to continue their medication. They have discovered, in consultation with their physicians, that the benefits of keeping their current medication outweigh any possible risks.
It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, as well as monitoring for signs of deterioration and the need for adjustments to the uk medication for adhd regimen.