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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications could affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological disorders like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge that more high-quality studies are needed.

Risk/Benefit Analysis

Women who are expecting and taking adhd medication cost medication must weigh the benefits of taking it against the possible dangers for the foetus. Physicians do not have the information needed to provide clear recommendations however they can provide information regarding the risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a higher risk of fetal malformations or structural birth defects. The researchers used a large population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to ensure that the classification was accurate and to minimize any bias.

The study conducted by the researchers was not without limitations. The researchers were not able in the beginning to distinguish the effects caused by the medication from the disorder. This limitation makes it difficult to know whether the small differences observed in the exposed groups are due to the use of medication or confounding by comorbidities. The researchers did not look at long-term outcomes for the offspring.

The study showed that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher chance of having a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages may be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman's condition. Physicians should talk to their patients about this and as much as possible, assist 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 keep treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are usually made without clear and reliable evidence. Instead, physicians must take into account their own experience, the experience of other physicians and the research on the topic.

The issue of possible risks for infants can be difficult to determine. The research on this subject is based on observation rather than controlled studies and many of the findings are in conflict. Most studies restrict their analysis to live births, which may underestimate the teratogenic impact leading to terminations or Adhd medication Pregnancy abortions of pregnancy. The study discussed in the journal club addresses these issues by analyzing data on live and deceased births.

The conclusion: While some studies have shown that there is a positive correlation between adhd medication without prescribing medications and the possibility of certain birth defects, other studies have found no connection, and most studies have a neutral or slightly negative impact. In each case an in-depth study of the benefits and risks is required.

It isn't easy, but not impossible, for women with ADHD to stop taking their medication. In fact, in an article recently published 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 these patients. A decrease in medication could also impact the ability to safely drive and complete work-related tasks, which are vital aspects of daily life for those suffering from ADHD.

She recommends women who are uncertain about whether to keep or stop taking medication because of their pregnancy should consider educating family members, friends and colleagues about the condition, its impact on daily functioning, and the advantages of staying on the current treatment regimen. It will also help a woman feel more confident in her decision. Certain medications can pass through the placenta. If the patient decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be transferred to the infant.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these medications could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Researchers utilized two massive data sets to examine over 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers discovered that, while 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 authors of the study didn't discover any link between early use of medication and other congenital anomalies, like facial deformities or club feet. The results are in the same vein as previous studies that have shown a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of the time of pregnancy. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication.

Women who took adhd medication pregnancy medication in the first trimester of their pregnancies were also more likely to experience caesarean section, low Apgar score following delivery, and a baby who required breathing assistance during birth. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who didn't have other medical issues that could have contributed to these findings.

The researchers hope their study will help inform the clinical decisions of physicians who encounter pregnant women. They advise that while discussing the risks and benefits is crucial, the decision to stop or keep medication should be based on the woman's needs and the severity of her ADHD symptoms.

The authors caution that, although stopping the medication is a possibility to consider, it is not advised due to the high prevalence of depression and mental health issues in women who are expecting or have recently given birth. Further, the research suggests that women who choose to stop their medications are more likely to experience difficulties adapting to life without them after the baby's arrival.

Nursing

It can be a stressful experience to become a mother. Women who suffer from ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to new routines. Many women decide to continue taking their adhd otc medication medication during pregnancy.

The risk to a breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. However, the rate of medication exposure to the newborn may differ based on the dosage, frequency it is administered, and the time of day the medication is administered. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isn't fully known.

Due to the absence of evidence, some doctors may recommend stopping stimulant medications during the pregnancy of a woman. This is a difficult decision for the woman, who must weigh the advantages of taking her medication as well as the risk to the foetus. As long as more information is available, doctors may inquire about pregnant patients if they have an history of ADHD or if they intend to take medication during the perinatal phase.

A increasing number of studies have proven that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. As a result, an increasing number of patients opt to do this and in consultation with their physician, they have discovered that the benefits of continuing their current medication far outweigh any potential risks.

Women with ADHD who are planning to nurse should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help women with ADHD understand their symptoms and the root cause and learn about treatments and to reinforce existing coping strategies. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration, and, if needed, adjustments to the medication regimen.