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. Little data exists about how long-term exposure to these medications could affect the 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 that further high-quality studies are required.
Risk/Benefit Analysis
Women who are expecting and taking
Adhd and depression medication medication for autism and adhd must weigh the benefits of taking it against the potential risks to the baby. Physicians do not have the information needed to provide clear recommendations, but they can provide information about risks and benefits that help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not face a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants in early pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure correct classification of the cases and to reduce the possibility of bias.
However, the study had 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 groups that were exposed to the use of medications or if they were affected by co-morbidities. Additionally the researchers did not study the long-term outcomes of offspring.
The study revealed that infants whose mother took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) in comparison to mothers who did not use any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This 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 uk buy online medication during pregnancy also had an increased chance of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases appeared to be independent of the type of medication used during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefit for both mother and child from continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies for improving their coping skills that may minimize the effects of her disorder on her daily functioning and relationships.
Interactions with Medication
More and more doctors are confronted with the dilemma of whether to maintain treatment or stop it 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 either way, so physicians must weigh what they know about their experiences, the experiences of other doctors, and what the research says on the topic and their own judgments for each individual patient.
The issue of possible risks to the infant can be particularly tricky. Many studies on this issue are based on observations instead of controlled research and their findings are often contradictory. The majority of studies limit their analysis to live births, which may underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study discussed in this journal club addresses these issues by analyzing data on live and deceased births.
The conclusion: While some studies have found a positive association between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies have a neutral or slight negative effect. In each case, a careful analysis of the risks and benefits is required.
For women suffering from ADHD, the decision to discontinue medication is difficult if not impossible. In an article published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping
adhd focus medication medication during pregnancy can cause depression, feelings of loneliness and family conflict for these patients. A decrease in medication could also affect the ability to safely drive and perform work-related tasks, which are vital aspects of normal life for those suffering from ADHD.
She recommends women who are unsure about whether to keep or stop taking medication because of their pregnancy consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily life, and the advantages of continuing the current treatment plan. It can also help women feel confident about her decision. Certain medications can be passed through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug could be passed on to her infant.
Birth Defects and Risk of
As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as does the concern about the potential adverse effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Researchers used two massive datasets to analyze over 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect.
The authors of the study found no connection between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in the same vein as previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the birth of their child. The risk grew in the latter half of pregnancy, when a lot of women begin to discontinue their ADHD medications.
Women who used ADHD medications during the first trimester of their pregnancy were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance at birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could have contributed to these findings.
Researchers hope that their study will help doctors when they encounter pregnant women. They suggest that although discussing risks and benefits is important however, the decision to stop or maintain medication should be based on each woman's requirements and the severity of her
adhd medication private prescription symptoms.
The authors also advise that while discontinuing the medications is an option, it is not a recommended practice because of the high incidence of depression and other mental health problems among women who are pregnant or recently post-partum. Research has also shown that women who stop taking their medication will have a tough adjustment to life without them once the baby is born.
Nursing
It can be a challenge to become a mother. Women who suffer from ADHD who must work through their symptoms while attending physician appointments, getting ready for the arrival of their 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 risk to a breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and time of day. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The impact on the health of a newborn isn't completely understood.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult choice for the patient, who must weigh the benefits of continuing her medication with the potential risks to the embryo. In the meantime, until more information is available, doctors can inquire about pregnant patients if they have an background of
adhd medication intuniv or if they are planning to take medication during the perinatal phase.
Numerous studies have proven that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. This has led to more and more 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.
Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help women with ADHD recognize their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatry. The pregnancy counselling should consist of discussion of a management plan for both mother and child, as well as monitoring for signs of deterioration and the need for adjustments to the medication regimen.