ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep Common adhd medications medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. There aren't enough data on how exposure to ADHD for a long time could affect a pregnant fetus.

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

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication must weigh the benefits of taking it against the potential risks for the baby. The doctors don't have the information to give clear advice however they can provide information on risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers used a vast population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during early pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate classification of the cases and to reduce the chance of bias.

The study conducted by the researchers was not without its limitations. In particular, they were unable to separate the effects of the medication from 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 the use of medications or if they were caused by co-morbidities. Additionally, the researchers did not look at long-term offspring outcomes.

The study revealed that infants whose mother had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission did not appear to be influenced by which stimulant medication was used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the small risks associated with the use ADHD medication during pregnancies in the early stages can be offset by more beneficial outcomes for both baby and mother of continued treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve their coping abilities which can reduce the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to maintain 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 in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what research says on the topic, along with their own judgments for each individual patient.

Particularly, the issue of possible risks to the baby can be a challenge. Many of the studies on this topic are based on observations rather than controlled research and their conclusions are often contradictory. Most studies limit their analysis to live births, which may 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 limitations by examining data on both live and deceased births.

Conclusion Some studies have found a positive correlation between ADHD medications and certain birth defects, other studies have not established a link. Most studies show a neutral, or even somewhat negative, effect. Therefore, a careful risk/benefit assessment is required in every situation.

For a lot of women with ADHD who suffer from ADHD, the decision to stop medication is difficult, if not impossible. 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 lead to increased depression, feelings of loneliness and family conflict for those suffering from the disorder. A loss of medication may affect the ability to drive safely and complete work-related tasks, which are vital aspects of normal life for those suffering from ADHD.

She suggests that women who are unsure about whether to continue or discontinue medication due to their pregnancy consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the advantages of continuing the current treatment regimen. It will also help a woman feel supported in her decision. It is important to remember that certain medications can pass through the placenta, so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the medication could be transferred to the infant.

Risk of Birth Defects

As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the possible effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Researchers utilized two massive datasets to analyze over 4.3 million pregnancy and determine if stimulant medication use caused birth defects. While the overall risk remains low, the scientists found that exposure in the first trimester to ADHD medicines was associated with an increased risk of specific heart defects, such as ventriculo-septal defect (VSD).

The researchers of the study could not find any association between the use of early medications and congenital anomalies like facial deformities, or club feet. The results are in the same vein as previous studies that showed a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the time of pregnancy. The risk was higher during the latter part of pregnancy, when many women begin to discontinue their ADHD medications.

Women who took ADHD medication during the first trimester were more likely require a caesarean birth or have an insufficient Apgar after birth and had a baby that required help breathing when they were born. However, the authors of the study were unable to eliminate selection bias by limiting the study to women who didn't have any other medical conditions that could have contributed to these findings.

Researchers hope that their research will help doctors when they encounter pregnant women. The researchers recommend that while discussing benefits and risks are crucial, the decision on whether to continue or stop 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 isn't a recommended practice because of the high incidence of depression and other mental health problems for women who are expecting or who are recently postpartum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have difficulties getting used 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 who have to deal with their symptoms while attending physician appointments and preparing for the arrival of a child and getting used to new routines at home may face a lot of challenges. Therefore, many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The majority of stimulant drugs are absorbed through breast milk in small quantities, so the risk for breastfeeding infant is minimal. However, the amount of medication exposure to the newborn can vary depending on the dosage, frequency it is administered and the time of the day the medication is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn isn't completely comprehended.

Due to the absence of research, some doctors might be tempted to stop taking stimulant drugs during the course of pregnancy. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the potential 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 planning or taking to take medication during the perinatal time.

Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, an increasing number of patients are choosing to do this. They have found, in consultation with their physicians, that the benefits of continuing their current medication far outweigh any potential risks.

It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continuing treatment, including non prescription adhd medication for adults-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with adhd otc medication recognize the signs and the underlying disorder. They should also be educated about treatment options and build strategies for coping. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.