The Three Greatest Moments In ADHD Medication Pregnancy History
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is a challenge for women suffering from the condition. There aren't enough data on how long-term exposure may affect a foetus.
best adhd medication published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the fetus. Physicians don't have the necessary data to make unequivocal recommendations, but they can provide information regarding 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 have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast, population-based case-control study to determine the prevalence of major structural birth defects in babies 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 limit the chance of bias.
However, the study had its limitations. The researchers were unable to, in the first place, to separate the effects of the medication from the disorder. This makes it difficult for researchers to determine whether the small associations observed among the groups that were exposed to the use of medication or confounded by the presence of comorbidities. Additionally, the researchers did not examine the long-term effects of offspring on their parents.
The study found that infants whose mother took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers 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 increased risk of admission was not found to be influenced by which stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a baby born with low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve coping skills which can reduce the effects of her disorder on her daily functioning and relationships.
Medication Interactions
Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors must weigh what they know, the experiences of other doctors, and what the research suggests on the subject and their own best judgment for each individual patient.
The issue of risk to infants is difficult to determine. Many of the studies on this subject are based on observational data rather than controlled research, and their conclusions are often contradictory. Additionally, the majority of studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues by analyzing both the data from deceased and live births.
Conclusion: While some studies have revealed a positive correlation between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. Most studies show a neutral, or even slight negative effect. As a result an accurate risk-benefit analysis is required in every instance.
It can be challenging, if not impossible for women suffering from 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 loneliness, and family conflict for patients with ADHD. A decrease in medication could also affect the ability to safely drive and to perform work-related tasks which are crucial aspects of normal life for those with ADHD.
She suggests that women who are not sure whether to continue taking medication or discontinue it due to pregnancy, educate their family members, colleagues, and acquaintances about the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. In addition, educating them can aid in ensuring that the woman feels supported in her struggle with her decision. It is also worth noting that certain drugs can pass through the placenta, so if a woman 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.
Birth Defects Risk
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns over the impact that these medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two massive data sets to examine over 4.3 million pregnant women and determine if stimulant medication use increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.
The researchers of the study could not discover any connection between the use of early medications and congenital anomalies like facial deformities, or club feet. The results are in line with previous studies that have shown a small but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk grew in the later part of pregnancy, when many women decide to stop taking their ADHD medications.
Women who took ADHD medication in the first trimester of pregnancy were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby who needed help breathing at birth. The authors of the study could not remove bias in selection since they limited their study to women without other medical conditions that might have contributed to the findings.
The researchers hope that their research will help inform the clinical decisions of doctors who see pregnant women. The researchers advise that while discussing benefits and risks are important, the decision about whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also caution that even though stopping the medication is an option, it is not an option that is recommended due to the high prevalence of depression and other mental health problems among women who are pregnant or recently postpartum. Further, research shows that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
The responsibilities of being a new mother can be overwhelming. Women with ADHD are often faced with a number of difficulties when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. This is why many women decide to continue taking their ADHD medications throughout pregnancy.
The risk to a breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The rate of exposure to medication will vary based on the dosage the medication is administered, its frequency and the time of day. Additionally, different medications are introduced into 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 known.
Because of the lack of research, some doctors might be tempted to stop taking stimulant medications during the pregnancy of a woman. 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 is available, doctors should ask all pregnant patients about their history of ADHD and if they plan or are taking to take medication during the perinatal time.
A growing number of studies have proven that most women can safely continue their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are opting to continue their medication. They have found, in consultation with their physicians, that the benefits of continuing their current medication outweigh potential risks.
Women with ADHD who are planning to nurse should seek advice from an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD be aware of their symptoms and underlying disorder and learn about treatments and to reinforce existing coping strategies. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration, and, if necessary modifications to the medication regimen.