20 Trailblazers Are Leading The Way In ADHD Medication Pregnancy
20 Trailblazers Are Leading The Way In ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these drugs could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental conditions like impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the advantages of taking them against the potential risks to the fetus. Doctors don't have enough data to provide clear recommendations but they can provide information on the risks and benefits to assist pregnant women to make informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face an 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 who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure an accurate classification of the cases and to reduce the chance of bias.
The study conducted by the researchers was not without limitations. In particular, they were unable to separate the effects of the medication from those of the disorder at hand. This limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to medication use or comorbidities that cause confusion. The researchers did not look at the long-term effects for the offspring.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had cut back on their medications prior to or during pregnancy. This increase was due to central nervous system-related disorders, and the higher risk of admission was not found to be influenced by which stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These risks did not appear to be influenced by the kind of medication used during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both the mother and child from continued treatment for the woman's disorder. Physicians should speak with their patients about this and, if possible, help them develop coping skills that may reduce the impact of her disorder in her daily life and relationships.
Medication Interactions
Many doctors are faced with the decision of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are taken in the absence of any evidence that is clear and definitive regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what the research suggests about the subject and their own best judgment for each individual patient.
In particular, the issue of potential risks for the baby can be tricky. A lot of studies on this topic are based on observations rather than controlled research and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which could underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both data on live and deceased births.
Conclusion: While some studies have found an association between ADHD medications and certain birth defects, other studies have not established a link. The majority of studies show an unintended, or slight negative effect. As a result an accurate risk-benefit analysis must be done in each situation.
It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In an article published in the Archives of Women's Mental Health, website psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for these patients. Additionally, the loss of medication can affect the ability to complete job-related tasks and drive safely that are crucial aspects of a normal life for a lot of people with ADHD.
She suggests that women who are unsure about whether to keep or discontinue medication due to their pregnancy should consider informing family members, friends, and coworkers on the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. Educating them can also make the woman feel more comfortable as she struggles with her decision. It is also worth noting that certain medications are able to be absorbed through the placenta therefore, if a patient decides to discontinue 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 might have on foetuses. 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 look at more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with a slightly higher rate of specific heart defects, such as ventriculoseptal defect (VSD).
The authors of the study found no association between the use of early medications and other congenital anomalies, like facial clefting, or club foot. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. This risk increased in the later part of pregnancy, when many women decide to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after birth and have a baby who needed help breathing at birth. However, the authors of the study were not able to eliminate selection bias by restricting the study to women who didn't have any other medical issues that could have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of doctors who see pregnant women. The researchers recommend 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 her requirements.
The authors warn that, while stopping the medication is an option to think about, it isn't recommended due to the high rate depression and other mental problems for women who are pregnant or who have recently given birth. Further, the research suggests that women who choose to stop taking their medications are more likely to have difficulties adapting to life without them following the birth of their baby.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women with ADHD who have to deal with their symptoms while attending doctor appointments, making preparations for the arrival of their child and adjusting to new household routines can experience severe challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The risk to a breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The rate of exposure to medication will vary based on the dosage, frequency of administration and the time of the day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not fully understood.
Some doctors may stop taking stimulant medication during a woman's pregnancy due to the lack of research. It's a difficult choice for the mother, who must weigh the advantages of taking her medication as well as the risk to the foetus. As long as there is no more information, doctors should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal time.
A growing number of studies have revealed that most women can safely continue their ADHD medication during pregnancy and breastfeeding. As a result, more and more patients choose to do so and, after consulting with their doctor, they have found that the benefits of continuing their current medication outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD recognize their symptoms and the underlying disorder and learn about treatment options and reinforce existing strategies for managing. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for indicators of deterioration, and, if necessary adjustments to the medication regimen.