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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. Little data exists about how adhd medication works long-term exposure to these drugs can affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental conditions like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication must consider the benefits of taking it against the possible dangers for the baby. Physicians don't have the data to provide clear recommendations, but can provide information on the risks and benefits to aid 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 have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was correct and to reduce any bias.

However, the researchers' study was not without its flaws. Most important, they were unable to separate the effects of the best medication for adhd combined type from the effects of the underlying disorder. That limitation makes it difficult to know whether the limited associations observed in the groups that were exposed result from medication use or confounding by comorbidities. In addition the researchers did not examine the long-term outcomes of offspring.

The study showed that babies whose mothers took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.

Researchers suggest that the minor risk of using ADHD medications during early pregnancies can be offset by greater benefits to both baby and mother of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, help them develop strategies to improve coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

Many doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors and the research on the subject.

The issue of potential risks to the infant can be particularly tricky. The research on this subject is based on observation rather than controlled studies and many of the findings are contradictory. The majority of studies focus on live births, which may underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these limitations by analyzing information on deceased and live births.

Conclusion Some studies have revealed an association between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies have shown a neutral, or even somewhat negative, impact. In each case an in-depth analysis of the risks and benefits must be performed.

It can be challenging, if not impossible, for women with ADHD to stop taking their medication. In fact, in an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for these patients. The loss of medication can affect the ability to drive safely and complete work-related tasks, which are essential aspects of normal life for those with ADHD.

She recommends that women who are unsure about whether to keep or discontinue medication due to their pregnancy, consider informing family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of continuing the current treatment plan. Educating them can also help the woman feel supported in her struggle with her decision. Some medications can pass through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it is crucial to be aware that the drug could be transferred to the infant.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers used two massive datasets to analyze more than 4.3 million pregnancies and determine if stimulant medication use caused birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher risk of specific heart defects like ventriculoseptal defect.

The researchers of the study could not discover any link between the use of early medications and congenital anomalies like facial deformities or club feet. The results are in line with previous studies showing an increase, but not significant, in the risk of heart malformations in women who started taking ADHD medications before pregnancy. The risk increased in the latter stages of pregnancy when many women decided to stop taking their medication.

Women who used ADHD medications during the first trimester of their pregnancies were also more likely to undergo a caesarean section, a low Apgar score after delivery and a baby who required help breathing at birth. However, the authors of the study were not able to eliminate bias due to selection by restricting the study to women who did not have any other medical issues that could be a contributing factor to these findings.

Researchers hope their research will help doctors when they see pregnant women. The researchers suggest that, while discussing the risks and benefits are important, the decision about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and the needs of the woman.

The authors also caution that even though stopping the medication what is the most common adhd medication prescribed an alternative, it is not an option to consider due to the high incidence of depression and other mental health issues among women who are pregnant or recently post-partum. Additionally, research suggests 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 overwhelming becoming a mother. Women with ADHD are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to new routines. As such, many women elect to continue taking their adhd non stimulant medication uk medications throughout the course of pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at a low level. The rate of medication exposure will differ based on dosage and frequency of administration as well as the time of day. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not well understood.

Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman who must weigh the benefits of continuing her medication against the risk to the fetus. Until more information becomes available, GPs can ask pregnant patients whether they have any history of ADHD or if they plan to take medication in the perinatal stage.

Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. As a result, many patients are choosing to do so and, in consultation with their doctor they have found that the benefits of continuing their current medication far exceed any risk.

Women who suffer from adhd medication pregnancy who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and strengthen coping mechanisms. This should be a multidisciplinary process together with obstetricians, GPs and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan best medicine for adhd and social anxiety both the mother as well as the child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.