10 Things You Learned In Kindergarden That Will Help You Get ADHD Medication Pregnancy
10 Things You Learned In Kindergarden That Will Help You Get ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There isn't much information on how long-term exposure to these drugs may affect the fetus.
A recent study 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 studies.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the advantages of using them against the risks to the fetus. Doctors don't have enough data to provide clear recommendations but they can provide information on risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. The researchers used a large population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to limit the chance of bias.
However, the study was not without its flaws. The most important issue was that they were unable to distinguish the effects of the medication from the underlying disorder. This limitation makes it difficult for researchers to determine whether the few associations observed between the groups that were exposed to medication use, or if they were confounded by co-morbidities. In addition, the researchers did not look at the long-term outcomes of offspring.
The study did reveal that infants whose mothers took ADHD medication during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk of admission was not found to be affected by the type of stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having a caesarean section or a baby that scored low on the Apgar scale (less than 7). These risks did not seem to be influenced by the type of medication that was used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the higher benefit for both mother and child from continued treatment for the woman's condition. Physicians should speak with their patients about this and as much as possible, assist them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the question of whether or not to stop treatment during pregnancy is one that more and more doctors have to face. Often, these decisions are made in the absence of solid and reliable evidence either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what research says on the topic as well as their own best judgment for each individual patient.
In particular, the issue of potential risks to the baby can be a challenge. Many studies on this subject are based on observational evidence rather than controlled research, and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues by analyzing data on live and deceased births.
The conclusion is that while some studies have shown that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link and the majority of studies have a neutral or slightly negative effect. In the end, a careful risk/benefit analysis must be conducted in every case.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In an article recently published in the 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. The loss of medication can also affect the ability to safely drive and perform work-related tasks, which are crucial aspects of normal life for people with ADHD.
She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy educate family members, coworkers and their friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also help women feel more confident in her decision. It is also worth noting that some medications are able to be absorbed through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug could be passed on to the baby.
Birth Defects Risk
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Researchers utilized two massive data sets to examine more than 4.3 million pregnant women and determine if the use of stimulant medications increased birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.
The authors of the study did not discover any link between the use of early medications and congenital anomalies such as facial deformities or club feet. The results are in line with previous studies which showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of the time of pregnancy. The risk increased in the latter stages of pregnancy, when a lot of women decided to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely need a caesarean and also have a low Apgar after delivery and had a baby that required breathing assistance at birth. However, the authors of the study were unable to eliminate selection bias 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 that their research will inform physicians when they encounter pregnant women. The researchers recommend that, while discussing the risks and benefits are important, the choice regarding whether or not to stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors warn that, even though 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 recently gave birth. Further, research shows that women who stop taking their medications will have a difficult adjustment to life without them after the baby is born.
Nursing
The responsibilities of 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. Many women opt to continue taking their ADHD medication during pregnancy.
The risk for nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. However, the amount of exposure to medication by the infant can differ based on dosage, how often it is administered and at what time it is administered. Additionally, different medications enter the infant's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not yet fully understood.
Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must balance the benefit of continuing her medication with the potential dangers to the foetus. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal time.
A growing number of studies have shown that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, an increasing number of patients are opting to do so. They have found after consulting with their doctors that the benefits of continuing their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor, and the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD recognize their symptoms and underlying disorder Learn get more info about the available treatments and to reinforce existing strategies for coping. This should be a multidisciplinary approach including obstetricians, GPs and psychiatry. Counselling for pregnancy should include discussion of a management plan for both the mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.