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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how exposure to ADHD for a long time could affect the fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental conditions 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

Pregnant women who take ADHD medications need to balance the advantages of using them against the risks to the foetus. Physicians don't have the data needed to make unequivocal recommendations, but they can provide information about benefits and risks that can help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during 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 took stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists examined the cases to ensure accurate case classification and to minimize the chance of bias.

The research conducted by the researchers had some limitations. Most important, they were not able to differentiate the effects of the medication from those of the disorder at hand. This makes it difficult to determine whether the small differences observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. The researchers did not look at long-term outcomes for the offspring.

The study found that babies whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not take any medication during pregnancy or stopped taking their medication before or during pregnancy. The reason for this was central nervous system-related disorders and the increased risk of admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.

Researchers suggest that the minor risk of using ADHD medications in early pregnancies may be offset by the greater benefits for mother and baby from continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies to improve coping skills that can lessen the impact of her disorder on her daily functioning and relationships.

Medication Interactions

Many doctors are faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made without clear and authoritative evidence regardless, so doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests about the subject and their best adhd medication for adults judgment for each patient.

Particularly, the subject of possible risks to the infant can be difficult. A lot of studies on this subject are based on observational data instead of controlled research and their conclusions are often contradictory. Most studies focus on live births, which can underestimate the teratogenic impact that can a doctor prescribe adhd medication without a diagnosis lead to terminations or abortions of pregnancy. The study discussed in this journal club addresses these issues by looking at data from both live and deceased births.

The conclusion is that while some studies have found a positive association between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies have a neutral or slightly negative effect. In all cases an in-depth analysis of the potential risks and benefits should be conducted.

For women suffering from ADHD and ADD, the decision to discontinue medication can be difficult, if not impossible. In fact, in an article published in the 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. Furthermore, a loss of medication can interfere with the ability to complete work-related tasks and safely drive which are essential aspects of a normal life for a lot of people with ADHD.

She suggests that women who are unsure whether to take the medication or discontinue it due to pregnancy, educate their family members, colleagues, and acquaintances about the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. It is also worth noting that some medications can be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be passed on to the baby.

Birth Defects and Risk of

As the use and abuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the potential effects of these drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. With two massive data sets researchers were able analyze more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers found that exposure in the first trimester to ADHD medications was associated with a slightly higher rate of certain heart defects such as ventriculoseptal defect (VSD).

The researchers of the study found no connection between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in the same vein as previous studies that have shown a small, but significant increase in cardiac malformations for women who started taking Adhd Medication Pregnancy [Young-Holder-2.Federatedjournals.Com] medication prior to the time of pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women stopped taking their medication.

Women who used ADHD medications in the first trimester of their pregnancy were also more likely to have a caesarean section, a low Apgar score after delivery and a baby that required help breathing at birth. The researchers of the study could not eliminate bias due to selection because they limited their study to women without other medical conditions that might have contributed to the findings.

The researchers hope their study will serve to inform the clinical decisions of doctors who encounter pregnant women. They advise that while discussing the risks and benefits is crucial however, the decision to stop or continue medication must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also warn that while discontinuing the medications is an alternative, it is not an option that is recommended due to the high rate of depression and other mental health issues among women who are pregnant or who are recently post-partum. Further, the research suggests that women who decide to stop taking their medication are more likely to have a difficult time adjusting to life without them following the baby's arrival.

Nursing

It can be a challenge to become a mother. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to new routines. This is why many women choose to continue taking their ADHD medication throughout the pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at a low level. However, the amount of exposure to medication by the newborn can vary depending on dosage, frequency it is administered and the time of day it is administered. Additionally, 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 infant is not fully known.

Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. This is a complicated decision for the patient, who must weigh the benefits of keeping her medication against the possible dangers to the fetus. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal period.

A growing number of studies have proven that women can continue taking their ADHD medication during pregnancy and while breastfeeding. This has led to more and more patients are choosing to do so and in consultation with their physician, they have found that the benefits of keeping their current medication far outweigh any risks.

Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor, and the pros and cons for continuing treatment. This includes non stimulant adhd medication uk-pharmacological strategies. Psychoeducation is also required to help women with ADHD recognize their symptoms and the root cause, learn about available treatment options and reinforce existing coping strategies. This should involve a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if necessary adjustments to the medication regimen.