ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these drugs could affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing 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 need to balance the benefits of taking them against the potential risks to the foetus. Physicians don't have the information needed to provide clear recommendations, but they can provide information regarding the risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based study of case-control to assess the risk of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to limit the chance of bias.

The study of the researchers was not without its limitations. The most important issue was that they were unable to distinguish the effects of the medication from the disorder that is underlying. This makes it difficult for researchers to determine if the few associations observed between the groups that were exposed to the use of medication, or if they were affected by comorbidities. Researchers also did not examine long-term outcomes for the offspring.

The study found that infants whose mothers had taken ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared to those whose mothers didn't take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk of admission did not appear to be influenced by the stimulant medications were used during pregnancy.

Women who used 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 did appear to be unrelated to the type of medication used during pregnancy.

Researchers suggest that the minor risk of using ADHD medications in early pregnancies could be offset by the greater benefits for mother and baby from continuing treatment for the woman's condition. Physicians should talk to their patients about this and, if possible, help them develop coping strategies that could reduce the effects of her disorder on her daily functioning and her relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether to continue or end treatment during pregnancy is a question that more and more physicians face. Often, these decisions are made in the absence of solid and reliable evidence either way, so physicians have to weigh their experience, the experiences of other doctors, and what medication Is given For adhd the research says on the topic, along with their own best judgment for each patient.

Particularly, the issue of potential risks for the infant can be difficult. Many of the studies on this topic are based on observational data rather than controlled research, and their conclusions are often contradictory. Most studies focus on live births, which may underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these limitations by analyzing data on live and deceased births.

The conclusion: While some studies have shown an association between ADHD medications and the possibility of certain birth defects, others have found no such relationship, and most studies show a neutral or even slight negative effect. As a result, a careful risk/benefit assessment must be done in each case.

For a lot of women with ADHD, the decision to stop medication is difficult if not impossible. In fact, in a recent article in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness, and family conflict for patients with ADHD. Furthermore, a loss of medication can affect the ability to complete work-related tasks and safely drive, which are important aspects of a normal life for many people with ADHD.

She suggests women who are uncertain about whether to keep or stop taking medication because of their pregnancy should consider informing family members, friends and colleagues about the condition, its effects on daily life, and the advantages of staying on the current treatment regimen. It can also help women feel more confident in her decision. Certain medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could be passed on to her infant.

Risk of Birth Defects

As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing the concern over the potential adverse effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. With two massive data sets researchers were able examine more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The researchers of the study didn't find any association between the use of early medications and other congenital anomalies such as facial deformities or club feet. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication prior to pregnancy. This risk increased in the later part of pregnancy, when a lot of women decide to stop taking their ADHD medications.

Women who took ADHD medication in the first trimester were more likely to require a caesarean delivery or have a low Apgar after delivery, and had a baby that required breathing assistance at birth. The authors of the study could not remove bias in selection since they limited the study to women who did not have any other medical conditions that might have contributed to the findings.

Researchers hope their research will help doctors when they meet pregnant women. They recommend that, while discussing the benefits and risks is important, the decision to stop or maintain treatment should be based on the woman's needs and the severity of her ADHD symptoms.

The authors also advise that while discontinuing the medications is an option, it isn't a recommended practice because of the high prevalence of depression and other mental health problems among women who are pregnant or postpartum. Further, research shows that women who stop taking their medication will have a difficult transitioning to life without them once the baby is born.

Nursing

The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to new routines. As such, many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The majority of stimulant medicines are absorbed through breast milk in small quantities, so the risk for nursing infant is very low. However, the rate of medication exposure to the newborn can vary depending on dosage, how does adhd medication work for adults often it is taken and the time of the day the medication is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn isn't well known.

Due to the absence of research, some physicians may recommend stopping adhd medication weekends adults stimulant medications during the pregnancy of a woman. This is a difficult choice for the patient, who must balance the benefits of continuing her medication with the potential dangers to the embryo. Until more information becomes available, GPs can doctors prescribe adhd medication ask pregnant patients whether they have any background of ADHD or if they are planning to take medication in the perinatal stage.

A growing number of studies have shown that the majority of women are able to safely continue taking their adhd medication without prescribing medication while they are pregnant and nursing. This has led to an increasing number of patients choose to do so and, in consultation with their doctor they have discovered that the benefits of keeping their current medication far outweigh any potential risks.

Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the underlying disorder, learn about available treatments and to reinforce existing strategies for coping. This should include a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, and monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regime.