Ask Me Anything: 10 Responses To Your Questions About ADHD Medication Pregnancy
Ask Me Anything: 10 Responses To Your Questions About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how long-term exposure may affect a fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the advantages of using them against the risks to the foetus. Physicians don't have the data to make unambiguous recommendations but they can provide information on the risks and benefits to assist pregnant women to make informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers used a large population-based case control study to assess the frequency of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure accurate classification of the cases and to reduce the chance of bias.
The research conducted by the researchers was not without limitations. The researchers were not able in the beginning, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the small differences observed between the groups exposed were due to the use of medications, or if they were caused by comorbidities. Additionally the study did not look at the long-term effects of offspring on their parents.
The study did show that infants whose mothers took ADHD medications during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean birth or having a baby with a low Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages can be offset by greater benefits to both mother and baby from continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies to improve coping skills that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
Many doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are usually taken without clear and authoritative evidence. Instead, physicians must consider their own expertise, the experience of other physicians and the research that has been conducted on the subject.
Particularly, the subject of potential risks for the baby can be tricky. A lot of studies on this issue are based on observations rather than controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these issues by examining data on both live and deceased births.
Conclusion Some studies have shown an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies show an unintended, or somewhat negative, impact. Therefore, a careful risk/benefit analysis must be conducted in every instance.
For women suffering from ADHD, the decision to stop taking medication can be difficult, if not impossible. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. The loss of medication can affect the ability to safely drive and to perform work-related tasks which are vital aspects of everyday life for those with ADHD.
She suggests that women who are unsure whether to continue taking medication or discontinue it due to pregnancy, educate their family members, coworkers and their friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment. In addition, educating them can make the woman feel more comfortable in her struggle with her decision. It is important to remember that certain drugs can pass through the placenta, therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be transferred to the child.
Risk of Birth Defects
As the use and use of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the potential adverse effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Utilizing two huge data sets, researchers were able to look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects such as ventriculo-septal 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 showing a small but significant increase in the risk of developing cardiac malformations among women who began taking ADHD medications prior to the birth of their child. This risk increased during the latter stages of pregnancy, when a lot of women decided to stop taking their medication.
Women who took ADHD medications in the first trimester of pregnancy were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby that required breathing assistance during birth. The authors of the study were unable to eliminate selection bias because they restricted the study to women with click here no other medical conditions that might have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of physicians who treat pregnant women. The researchers advise that, while discussing benefits and risks are important, the choice about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors warn that, while stopping the medication is a possibility to look into, it is not recommended due to the high prevalence of depression and mental health issues in women who are expecting or recently gave birth. Further, the research suggests that women who decide to stop taking their medications are more likely to have difficulties adapting to life without them after the birth of their baby.
Nursing
The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, preparing for the arrival of a child and adjusting to new household routines are often faced with a number of difficulties. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small amounts, therefore the risk to the breastfeeding infant is minimal. However, the frequency of exposure to medication by the newborn can vary depending on dosage, frequency it is taken and at what time the medication is administered. In addition, various drugs enter the infant's system through the gastrointestinal tract or through breast milk. The impact of these medications on a newborn's health is not completely known.
Because of the lack of research, some physicians may recommend stopping stimulant medication during the course of pregnancy. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication against the possible risks to the embryo. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal time.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. In response, a rising number of patients are choosing to continue their medication. They have discovered after consulting with their physicians that the benefits of retaining their current medication outweigh any possible risks.
Women who suffer from ADHD who are planning to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for coping. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatry. Pregnancy counselling should include discussion of a management plan for both the mother as well as the child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.