ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these drugs can affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to Adhd medication pregnancy (www.mazafakas.com) medication during pregnancy do not develop neurological issues such as hearing loss or vision, 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 taking them against the potential risks to the fetus. Physicians don't have the information needed to make unequivocal recommendations, but they can provide information about risks and benefits that assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large population-based study of case-control to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy and those who had not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure correct case classification and to minimize the possibility of bias.

However, the researchers' study was not without its flaws. In particular, they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This limitation makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to medication use or if they were affected by co-morbidities. Researchers also did not examine long-term outcomes for offspring.

The study found that infants whose mothers took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who didn't take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk of admission was not found to be influenced by the stimulant medications were taken during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean delivery or having a baby with low Apgar score (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 risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the greater benefit to both mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this and, if possible, help them develop coping strategies that could reduce the effects of her disorder on her daily functioning and her relationships.

Interactions with Medication

Many doctors are faced with the decision of whether to continue treatment or stop as more women are diagnosed with ADHD. These decisions are usually taken without clear and authoritative evidence. Instead, physicians must consider their own expertise and experience, as well as the experiences of other doctors, and the research on the subject.

The issue of potential risks to infants is particularly tricky. The research on this subject is based on observation instead of controlled studies and a lot of the results are conflicting. Additionally, the majority of studies limit their analysis to live births, which can my general practitioner prescribe adhd medication underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by analyzing data on live and deceased births.

Conclusion: While some studies have shown an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies show an unintended, or somewhat negative, impact. Therefore an accurate risk-benefit analysis must be done in each case.

It can be difficult, if not impossible for women with ADHD to stop taking their medication. In fact, in an article published in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness, and family conflict for those suffering from the disorder. A decrease in medication could also impact the ability to safely drive and complete work-related tasks, which are crucial aspects of everyday life for those suffering from ADHD.

She recommends that women who are unsure about whether to keep or stop taking medication because of their pregnancy consider educating family members, friends and colleagues about the condition, its impact on daily functioning, and the benefits of keeping the current treatment plan. It can also help a woman feel confident about her decision. It is important to note that certain medications can be absorbed through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be passed on to the baby.

Birth Defects and Risk of

As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing the concern over the potential adverse effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers utilized two massive data sets to examine over 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.

The researchers behind the study found no link between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are in agreement with previous studies that have shown a small, but significant increase in cardiac malformations for women who started taking ADHD medication before pregnancy. The risk was higher during the latter part of pregnancy, when many women begin to discontinue their medication.

Women who took ADHD medication during the first trimester were more likely require a caesarean delivery and also have an insufficient Apgar after delivery, and have a baby that needed breathing assistance when they were born. The authors of the study could not eliminate bias due to selection because they limited the study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope that their research will aid in the clinical decisions of physicians who see pregnant women. They recommend that, while discussing the benefits and risks is important but the decision to stop or maintain medication should be based on the woman's needs and the severity of her ADHD symptoms.

The authors also caution that, while stopping the medication is an alternative, it is not an option that is recommended due to the high incidence of depression and other mental health issues in women who are pregnant or who are recently post-partum. Further, research shows that women who stop taking their medication will have a harder transitioning to life without them once the baby is born.

Nursing

It can be a stressful experience to become a mom. Women with ADHD are often faced with a number of difficulties when they must deal with their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs are absorbed by breast milk in very small quantities, so the risk for nursing infant is very low. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and the time of the day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't well known.

Because of the lack of research, some physicians might be tempted to stop taking stimulant drugs during a woman's pregnancy. This is a complicated decision for the patient, who must balance the benefit of continuing her medication against the possible dangers to the fetus. Until more information becomes available, GPs can ask pregnant patients whether they have an background of ADHD or if they are planning to take medication during the perinatal period.

A increasing number of studies have proven that most women can safely continue taking their ADHD medication during pregnancy and breastfeeding. As a result, an increasing number of patients are choosing to do so and, in consultation with their doctor they have discovered that the benefits of continuing their current medication far outweigh any potential 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 discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non stimulant adhd medications for adults-pharmacological methods. Psychoeducation is also needed to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should be a multidisciplinary process with the GPs, obstetricians, and psychiatrists. Pregnancy counselling should include discussion of a management plan for both mother and child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.