10 Apps To Aid You Control Your ADHD Medication Pregnancy
ADHD Medication During Pregnancy and BreastfeedingThe decision to stop or continue ADHD medication during pregnancy and nursing is a difficult decision for women suffering from the condition. Little data exists 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 during the uterus don't develop neurological disorders like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of taking them against potential risks to the fetus. Doctors don't have the necessary data to provide clear recommendations however they can provide information regarding benefits and risks that can aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large population-based case control study to compare the incidence of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was correct and to reduce any bias.
The study of the researchers was not without limitations. The most important issue was that they were unable to separate the effects of the medication from the underlying disorder. This makes it difficult to know whether the small differences observed in the exposed groups are due to medication use or comorbidities that cause confusion. Additionally the researchers did not study the long-term effects of offspring on their parents.
The study showed that infants whose mothers took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared 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 of admission was not found to be influenced by the stimulant medications were used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a child with an low Apgar score (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both the mother and child of continued treatment for the woman's condition. Physicians should discuss this with their patients and, if they are able, assist them in developing strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made without any evidence that is clear and definitive regardless, so doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what the research suggests about the subject, along with their own best judgment for each patient.
The issue of possible risks to the infant can be difficult to determine. Many studies on this subject 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 undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues by analyzing data on live and deceased births.
Conclusion: While some studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies show a neutral, or even slightly negative, impact. In every case it is imperative to conduct a thorough analysis of the benefits and risks is required.
It can be challenging, if not impossible, for women with ADHD to stop taking their medication. In fact, in an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for those suffering from the disorder. A decrease in medication could affect the ability to drive safely and complete work-related tasks, which are vital aspects of everyday life for people with ADHD.
She suggests that women who are unsure whether to take the medication or discontinue it due to pregnancy educate family members, coworkers and friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also help a woman feel confident about her decision. It is important to note that some medications can pass through the placenta, so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be passed on to the baby.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers used two massive datasets to analyze over 4.3 million pregnancies and determine if the use of stimulant medications caused birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study could not discover any connection between the use of early medications and other congenital anomalies like facial deformities or club feet. The results are in line with previous studies revealing an increase, but not significant, in the risk of heart malformations in women who started taking ADHD medications prior to the time of the birth of their child. The website risk was higher in the latter half of pregnancy, when a lot of women decide to stop taking their ADHD medications.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean delivery, have a low Apgar after delivery and had a baby that required help breathing after 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 any other medical conditions that could be a contributing factor to these findings.
Researchers hope their research will provide doctors with information when they meet pregnant women. The researchers advise that while discussing benefits and risks are crucial, the decision on whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and her requirements.
The authors also advise that while discontinuing the medications is an alternative, 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. Furthermore, research suggests that women who decide to stop taking their medication are more likely to have a difficult time getting used to life without them following the birth of their baby.
Nursing
The responsibilities of being a new mother can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments and making preparations for the arrival of a child and getting used to new routines at home can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed by breast milk in small amounts, therefore the risk for breastfeeding infant is minimal. However, the rate of exposure to medication by the newborn may differ based on dosage, frequency it is administered, and the time of the day the medication is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn is not yet fully understood.
Because of the lack of research, some doctors may be inclined to discontinue stimulant drugs during the pregnancy of a woman. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risks to the foetus. As long as more information is available, GPs can ask pregnant patients whether they have any history of ADHD or if they plan to take medication during the perinatal stage.
A increasing number of studies have proven that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. This has led to an increasing number of patients choose to do so and after consulting with their doctor, they have discovered that the benefits of continuing their current medication far outweigh any potential risks.
It is essential for women with ADHD who are considering breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should be a multidisciplinary process with the GPs, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, as well as monitoring for indicators of deterioration, and, if needed modifications to the medication regime.