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ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or continue ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There aren't many studies regarding how exposure over time may affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD best medication for adhd during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against potential risks to the foetus. Physicians don't have the data to give clear advice however they can provide information on the risks and benefits to aid pregnant women in making an informed decision.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a massive population-based case control study to examine the prevalence of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to make sure that the classification was accurate and to reduce any bias.

However, the researchers' study had its limitations. Most important, they were unable to distinguish the effects of the medication from the disorder that is underlying. That limitation makes it difficult to know whether the small associations observed in the exposed groups are due to medication use or the confounding effect of comorbidities. In addition the study did not examine the long-term effects of offspring on their parents.

The study found 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 those whose mothers did not take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk for admission was not found to be influenced by which stimulant medications were used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy.

Researchers suggest that the minor risks associated with the use ADHD medications during early pregnancies can my general practitioner prescribe adhd medication be offset by greater benefits to both baby and mother of continued treatment for the woman’s disorder. Doctors should discuss with their patients about this issue and try to help them improve coping skills which may reduce the effects of her disorder on her daily functioning and her relationships.

Medication Interactions

As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or end treatment during pregnancy is one that more and more doctors face. These decisions are usually made without clear and authoritative evidence. Instead, physicians must take into account their own experience, the experience of other doctors, and the research that has been conducted on the subject.

The issue of risk for infants can be difficult to determine. The research that has been conducted on this topic is based on observations instead of controlled studies and the results are in conflict. Most studies limit their analysis to live births, which may underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study presented 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, others have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative impact. In each case an in-depth study of the risks and benefits should be conducted.

For many women with ADHD and ADD, the decision to stop taking medication can be difficult, if not impossible. In fact, in a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for those suffering from the disorder. The loss of medication can also affect the ability to safely drive and to perform work-related tasks which are essential aspects of everyday life for people with adhd medication not working.

She suggests that women who are unsure whether to continue taking medication or stop due to pregnancy should educate family members, coworkers, and acquaintances about the condition, its effects on daily functioning, and the advantages of staying on the current treatment. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is crucial to be aware that the drug may be transferred to her baby.

Risk of Birth Defects

As the use and use of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases as does the concern about the potential effects of these drugs on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers used two huge data sets to study over 4.3 million pregnancy and determine if stimulant medication use caused birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects, like ventriculo-septal defects (VSD).

The authors of the study found no connection between early medication use and other congenital abnormalities, like facial clefting, or club foot. The results are in agreement with previous studies which showed a small, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the birth of their child. This risk increased in the latter half of pregnancy, as many women are forced to stop taking their medication.

Women who took adhd Medication pregnancy; promarket.In.ua, medications in the first trimester of their pregnancies were also more likely to have a caesarean section, a low Apgar score after delivery and a baby who needed breathing assistance at birth. The authors of the study were unable to eliminate bias due to selection because they limited the study to women with no other medical conditions that might have contributed to the findings.

The researchers hope that their research will serve to inform the clinical decisions of physicians who treat pregnant women. They suggest that although the discussion of the benefits and risks is important but the decision to stop or maintain medication should be based on the woman's needs and the severity of her ADHD symptoms.

The authors also advise that, while stopping the medication is an option, it is not a recommended practice because of the high rate of depression and other mental health problems in women who are pregnant or who are recently post-partum. Further, research shows that women who stop taking their medications will have a difficult transitioning to life without them after the baby is born.

Nursing

The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to new routines. This is why many women decide to continue taking their ADHD medications throughout pregnancy.

The majority of stimulant drugs pass through breast milk in low quantities, so the risk to infant who is breastfeeding is low. The rate of medication exposure can vary depending upon the dosage, frequency of administration and the time of the day. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn is not yet fully understood.

Due to the absence of evidence, some doctors may recommend stopping stimulant medications during a woman's pregnancy. This is a difficult decision for the woman, who must weigh the benefits of taking her medication as well as the risks to the foetus. Until more information becomes available, doctors may ask pregnant patients whether they have a history of ADHD or if they intend to take medication during the perinatal phase.

Numerous studies have proven that women can continue to take their ADHD medication without risk while breastfeeding and during pregnancy. In response, an increasing number of patients are choosing to continue their medication. They have discovered through consultation with their doctors that the benefits of continuing their current medication far outweigh any possible risks.

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 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 underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should be an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, monitoring of indicators of deterioration, and, if necessary, adjustments to the medication regimen.