ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD face a difficult decision 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 the fetus.

A study recently published in Molecular Psychiatry shows that children exposed to adhd medication without prescribing medication in the uterus don't develop neurological disorders like 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 medication should evaluate the benefits of using it versus the risks to the baby. The doctors don't have the information to give clear advice however they 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 a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a massive sample-based case control study to assess the frequency of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to minimize the possibility of bias.

The research conducted by the researchers was not without its limitations. Most important, they were unable to distinguish the effects of the medication from the effects of the disorder that is underlying. 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 study did not examine the long-term effects of offspring on their parents.

The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a 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. This was due to central nervous system disorders. The increased risk of admission was not affected by the stimulant medications used during pregnancy.

Women who took stimulant adhd non stimulant medication uk medications during pregnancy also had a higher likelihood 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.

The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit to both the mother and child of continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and, if possible, help them develop coping with adhd without medication skills that can lessen the effects of her disorder on her daily life and relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are taken in the absence of any evidence that is clear and definitive regardless, so doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests on the subject and their own best judgment for each individual patient.

Particularly, the issue of potential risks for the baby can be tricky. The research on this subject is based on observation instead of controlled studies and many of the findings are contradictory. Furthermore, most studies restrict their analysis to live births, which could underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study presented in the journal club addresses these limitations by analyzing both the data from deceased and live births.

Conclusion Some studies have found an association between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies have shown a neutral, or even slightly negative, effect. In all cases it is imperative to conduct a thorough analysis of the risks and benefits should be conducted.

For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of being isolated. A loss of medication may also impact the ability to safely drive and perform work-related tasks, which are vital aspects of normal life for those suffering from ADHD.

She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy should educate family members, coworkers and friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment plan. It will also help a woman feel confident about her decision. It is also worth noting that certain medications are able to be absorbed through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be passed on to the baby.

Risk of Birth Defects

As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases as does the concern about the possible effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Researchers utilized two massive data sets to study over 4.3 million pregnant women and determine if the use of stimulant medications increased birth defects. While the overall risk remains low, the scientists found that exposure in the first trimester to ADHD medications was linked to an increased risk of certain heart defects such as ventriculoseptal defect (VSD).

The researchers behind the study found no association between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in agreement with previous studies which showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of pregnancy. The risk grew in the later part of pregnancy, when a lot of women begin to discontinue their ADHD medication.

Women who used ADHD medication in the first trimester of their pregnancies were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby that required help breathing at birth. The researchers of the study were unable to remove bias in selection since they limited the study to women with no other medical conditions that could have contributed to the findings.

The researchers hope their study will help inform the clinical decisions of doctors who treat pregnant women. The researchers suggest that while discussing risks and benefits are crucial, the decision regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and the needs of the woman.

The authors caution that, even though stopping adhd medication adults the medication is a possibility to look into, it is not recommended due to the high rate depression and mental health issues for women who are pregnant or have recently given birth. Furthermore, research suggests that women who decide to stop taking their medication are more likely to experience difficulties adjusting to life without them after the baby's arrival.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women with ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant medications are absorbed by breast milk in low quantities, so the risk for breastfeeding infant is minimal. However, the amount of medication exposure to the newborn may differ based on dosage, how often it is administered and the time of day it is administered. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not fully understood.

Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the possible risks to the embryo. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal time.

Many studies have shown that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. This has led to an increasing number of patients opt to do this and after consulting with their doctor, they have found that the benefits of continuing their current medication outweigh any risks.

Women with Adhd medication pregnancy who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder and learn about treatments and to reinforce existing coping strategies. This should involve a multidisciplinary approach, which includes 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 signs of deterioration, and, if necessary modifications to the medication regimen.