ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how long-term exposure to these drugs may affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.

Risk/Benefit Analysis

Pregnant women who use ADHD medications must weigh the benefits of taking them against the potential risks to the foetus. Doctors don't have enough data to give clear advice but they can provide information on risks and benefits to aid pregnant women in making an informed decision.

A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not face an increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large, population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to reduce any bias.

The research conducted by the researchers was not without limitations. Researchers were unable to, in the first place, to separate the effects caused by the medication from the disorder. This makes it difficult to determine whether the limited associations observed in the groups that were exposed result from medication use or comorbidities that cause confusion. Researchers also did not look at the long-term effects for the offspring.

The study did show that infants whose mothers took ADHD medication during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the increased risk for admission was not found to be influenced by the stimulant medication was used during pregnancy.

Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a baby born with an low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.

The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit for both mother and child of continued treatment for the woman's disorder. Doctors should discuss with their patients about this and try to help them develop coping strategies that may reduce the impact of her disorder in her daily functioning and her relationships.

Interactions with Medication

Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with adhd and medication. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must consider their own expertise and experience, as well as the experiences of other doctors, and the research on the topic.

Particularly, the issue of potential risks to the baby can be tricky. Many of the studies on this issue are based on observational data rather than controlled research and their conclusions are often contradictory. The majority of studies focus on live-births, which could underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these issues by examining data on both live and deceased births.

The conclusion is that while certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no connection, and most effective adhd medication for adults uk studies demonstrate a neutral or slightly negative impact. In all cases an in-depth study of the benefits and risks should be conducted.

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 increase depression and feelings of loneliness. The loss of medication can also affect the ability to drive safely and complete work-related tasks, which are essential aspects of daily life for those suffering from ADHD.

She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy, educate their family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the benefits of continuing the current treatment plan. Educating them can also help the woman feel supported as she struggles with her decision. It is important to remember that some medications are able to pass through the placenta, so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the child.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers used two huge datasets to analyze more than 4.3 million pregnant women and determine if stimulant medication use increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD medication use was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.

The authors of the study could not discover any connection between early use of medication and congenital anomalies like facial deformities or club feet. The results are in line with previous studies that showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of the time of pregnancy. The risk increased in the latter part of pregnancy, when a lot of women stopped taking their medication.

Women who were taking ADHD medication during the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after birth and have a baby that needed breathing assistance when they were born. However the researchers of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could have contributed to the findings.

Researchers hope that their research will provide doctors with information when they encounter pregnant women. They suggest that although the discussion of risks and benefits is important but the decision to stop or keep treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors also caution that, while stopping the medication is an option, it isn't an option that is recommended due to the high incidence of depression and other mental health issues for women who are expecting or post-partum. Additionally, the research suggests that women who choose to stop taking their medication are more likely to have difficulties adapting to life without them following the baby's arrival.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments, preparing for the arrival of a child and adjusting to new household routines are often faced with a number of difficulties. This is why many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The majority of stimulant medications pass through breast milk in small amounts, therefore the risk to nursing infant is very low. However, the frequency of medication exposure to the newborn can vary depending on dosage, how often it is administered and at what time the medication is administered. 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 infant is not fully understood.

Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the absence of research. This is a complicated decision for the patient, who must balance the benefit of continuing her medication with the potential risks to the embryo. As long as more information is available, GPs may ask pregnant patients whether they have a history of ADHD or if they intend to take medication during the perinatal stage.

Numerous studies have proven that women can you get adhd medication without a diagnosis (click this) continue to take their ADHD medication without risk during pregnancy and while breast-feeding. This has led to an increasing number of patients opt to do this, and in consultation with their physician, they have found that the benefits of keeping their current medication far outweigh any potential risks.

It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications 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 their symptoms and the underlying disorder, learn about available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs and psychiatrists. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.