Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There are few data regarding how exposure over time may affect the fetus.A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or 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 must weigh the advantages of taking them against the potential risks to the fetus. The doctors don't have the information to provide clear recommendations however they can provide information on the risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was accurate and to minimize any bias.
However, the study had its limitations. Researchers were unable, in the first place, to separate the effects triggered by the medication from the disorder. This makes it difficult for researchers to establish whether the small associations observed among the groups that were exposed to the use of medication or confounded by comorbidities. Researchers also did not examine long-term outcomes for the offspring.
The study found that infants whose mother had taken ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers didn't take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system-related disorders and the increased risk for admission was not found to be influenced by the stimulant medications were taken during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean section or having a baby born with low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medication during pregnancies in the early stages may be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman's condition. Physicians should talk to their patients about this issue and try to help them improve coping skills which could reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of solid and reliable evidence regardless, so doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests on the subject and their own best judgment for each patient.
In particular, the issue of potential risks for the infant can be difficult. The research on this issue is based on observation rather than controlled studies and many of the findings are conflicting. The majority of studies focus on live births, which can underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
Conclusion Some studies have revealed an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most Popular Adhd Medication - Www.Nzdao.Cn, studies show that there is a neutral, or slight negative effect. In every case an in-depth evaluation of the potential risks and benefits should be conducted.
It can be difficult, if not impossible for women with ADHD to stop taking their medication. In fact, in a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping online adhd medication medication during pregnancy can cause depression, feelings of loneliness, and family conflict for patients with ADHD. A loss of medication may also affect the ability to drive safely and to perform work-related tasks which are vital aspects of normal life for people with ADHD.
She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy should educate family members, colleagues, and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment plan. It can also help a woman feel supported in her decision. It is also worth noting that some medications are able to pass through the placenta, so if a woman decides to stop taking her adhd sleep medication list medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug can be transferred to the child.
Risk of Birth Defects
As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, such as ventriculo-septal defect (VSD).
The researchers of the study did not discover any connection between the use of early medications and other 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 cardiac malformations for women who started taking ADHD medication prior to the birth of their child. This risk increased during the latter part of pregnancy when a large number of women decided to stop taking their medication.
Women who used ADHD medication in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score after delivery and a baby that required breathing assistance during birth. The authors of the study could not remove bias in selection since they limited their study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope their study will serve to inform the clinical decisions of physicians who see pregnant women. The researchers recommend that while discussing risks and benefits are crucial, the decision regarding whether or not to stop medication should be made in light of the severity of each woman's ADHD symptoms and the needs of the woman.
The authors warn that, although stopping the medication is a possibility to think about, it isn't recommended due to the high prevalence of depression and other mental disorders in women who are expecting or have recently given birth. Additionally, research suggests that women who stop taking their medication will have a harder adjustment to life without them after the baby is born.
Nursing
The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments, getting ready for the arrival of a child and getting used to new routines at home are often faced with a number of difficulties. Many women opt to continue taking their adhd no medication medication during pregnancy.
The majority of stimulant medications are absorbed by breast milk in very small quantities, so the risk to breastfeeding infant is minimal. However, the frequency of exposure to medications by the newborn can vary depending on dosage, frequency it is administered, and at what time the medication is administered. Additionally, different adhd medications drugs enter the infant's system via the gastrointestinal tract, or through breast milk. The impact on a newborn's health is not fully known.
Due to the absence of evidence, some doctors may recommend stopping stimulant drugs during a woman's pregnancy. This is a difficult decision for the mother, who must weigh the advantages of taking her medication as well as the risk to the embryo. As long as more information is available, GPs may ask pregnant patients if they have any background of ADHD or if they plan to take medication during the perinatal stage.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. This has led to many patients choose to do so and after consulting with their doctor, they have found that the benefits of maintaining their current medication far outweigh any risks.
It's important for women with ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their doctor, and the pros and cons of continuing treatment. This includes non prescription adhd medication-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach together with obstetricians, GPs and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration and, if necessary modifications to the medication regimen.