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ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medication during pregnancy and nursing is a difficult decision for women suffering from the condition. There aren't enough data regarding how exposure over time may affect a fetus.

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

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the advantages of taking them against the potential risks to the foetus. Physicians do not have the necessary data to provide clear recommendations however they can provide information on benefits and risks that can aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large population-based case control study to compare the incidence of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was accurate and to eliminate any bias.

However, the study had its limitations. The researchers were unable to, in the first place to differentiate the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine whether the few associations observed between the groups exposed were due to medication use or affected by the presence of comorbidities. In addition the researchers did not study long-term offspring outcomes.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not affected by the stimulant medications used during pregnancy.

Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean birth or having a baby with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.

The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit for both mother and child of continued treatment for the woman's disorder. Doctors should discuss with their patients about this and try to help them improve coping skills which may reduce the impact of her disorder in her daily life and relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and treated with medication, the question of whether or not to stop treatment during pregnancy is a question that more and more physicians confront. These decisions are often made without clear and reliable evidence. Instead, physicians must take into account their own experience in conjunction with the experiences of other doctors and the research that has been conducted on the subject.

The issue of possible risks for infants can be particularly tricky. The research on this subject is based on observation rather than controlled studies, and many of the findings are in conflict. The majority of studies focus on live births, which may underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these issues by analyzing information on deceased and live births.

The conclusion The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship, and most studies have a neutral or slightly negative impact. In the end, a careful risk/benefit analysis is required in every instance.

It isn't easy, but not impossible for women suffering from safest adhd medication for adults 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 lead to increased depression, feelings of loneliness and family conflict for those suffering from the disorder. A loss of medication may affect the ability to drive safely and perform work-related tasks, which are essential aspects of daily life for those with ADHD.

She suggests that women who aren't sure whether to continue taking the medication or discontinue it due to pregnancy educate family members, coworkers and their friends about the condition, its impact on daily functioning and the benefits of keeping the current treatment regimen. In addition, educating them can help the woman feel supported in her struggle with her decision. It is important to remember that some medications can pass through the placenta so if a woman decides to stop her ADHD Best Medication For Inattentive Adhd during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the infant.

Birth Defects and Risk of

As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases the concern over the possible effects of the drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine if the use of stimulant medications caused birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increased risk of certain heart defects, like ventriculo-septal defects (VSD).

The researchers of the study found no link between early medication use and other congenital anomalies, such as facial clefting or club foot. The results are in the same vein as previous studies that have shown a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication before the time of pregnancy. The risk grew during the latter part of pregnancy, as many women decide to stop taking their medication.

Women who took ADHD medications in the first trimester of their pregnancies were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby who required help breathing at birth. However the authors of the study were not able to eliminate selection bias by limiting the study to women who didn't have other medical issues that could be a contributing factor to these findings.

The researchers hope their study will serve to inform the clinical decisions of physicians who encounter pregnant women. The researchers suggest that, while discussing risks and benefits are crucial, the decision on 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 advise that, while stopping the medication is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health issues for women who are expecting or recently post-partum. Further, the research suggests that women who choose to stop their medications are more likely to have a difficult time adapting to life without them following the birth of their baby.

Nursing

The responsibilities of a new mother can be overwhelming. Women with ADHD who have to manage their symptoms while attending physician appointments, preparing for the arrival of a baby and getting used to new routines at home are often faced with a number of difficulties. Therefore, many women choose to continue taking their ADHD medications throughout pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medications is absorbed through breast milk at low levels. However, the rate of exposure to medication by the infant can differ based on dosage, frequency it is administered, and the time of day it is administered. In addition, various drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The impact of these medications on a newborn's health is not fully known.

Because of the lack of research, some physicians may recommend stopping stimulant medications during the course of pregnancy. This is a complicated decision for the patient, who must balance the benefit of continuing her medication against the possible risks to the fetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal time.

A increasing number of studies have shown that the majority of women are able to safely continue to take their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are choosing to do so. They have concluded through consultation with their doctor, that the benefits of retaining their current medication outweigh risk.

Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from common adhd medications be aware of their symptoms and underlying disorder and learn about treatment options and reinforce existing coping strategies. This should be a multidisciplinary process including obstetricians, GPs, and psychiatry. Counselling for pregnancy should include the discussion of a plan for management for both mother and child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.