25 Surprising Facts About ADHD Medication Pregnancy
25 Surprising Facts About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these medications may affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological developmental disorders like hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are required.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication must weigh the benefits of taking it against the potential risks for the foetus. Doctors don't have the necessary data to provide clear recommendations but they can provide information regarding the risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not face an increased risk of fetal cardiac malformations or major birth defects that are structural. 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, and those who did not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure correct case classification and to limit the chance of bias.
The study conducted by the researchers was not without limitations. Researchers were unable, in the first place to distinguish the effects of the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small differences observed between the groups that were exposed to the use of medications or if they were confounded by comorbidities. Additionally the study did not study the long-term outcomes of offspring.
The study did find that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or stopped their medications before or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean section or having a baby born with low Apgar score (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both the mother and child of continuing treatment for the woman's condition. Doctors should discuss with their patients about this issue and try to help them develop coping skills that could 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 question of whether to keep or discontinue treatment during pregnancy is a question that more and more physicians confront. The majority of these decisions are made without any evidence that is clear and definitive in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what the research suggests about the subject, along with their own best judgment for each patient.
The issue of risk to the infant can be particularly tricky. The research on this issue is based on observation rather than controlled studies and many of the findings are in conflict. In addition, most studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing both the data from deceased and live births.
Conclusion Some studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies show that there is a neutral, or slight negative impact. In the end, a careful risk/benefit assessment must be done in each instance.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In a recent piece published 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 isolation. The loss of medication can affect the ability to safely drive and to perform work-related tasks which are crucial aspects of everyday life for those with ADHD.
She recommends that women who are unsure about whether to keep or stop medication in light of their pregnancy consider informing family members, friends, and coworkers on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment plan. In addition, educating them can make the woman feel more comfortable in her struggle with her decision. It is important to remember that some drugs can pass through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be transferred to the child.
Birth Defects and Risk of
As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, the first trimester ADHD medication use was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.
The authors of the study found no connection between early use of medication and congenital abnormalities like facial clefting, or club foot. The results are in the same vein as previous studies that showed the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication before the time of pregnancy. This risk increased during the latter half of pregnancy, when a lot of women decided to stop taking their medication.
Women who used ADHD medication in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score after delivery and a baby that required help breathing at birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could have contributed to the findings.
Researchers hope that their research will inform physicians when they see pregnant women. The researchers advise that, while discussing risks and benefits are important, the decision about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and the needs of the woman.
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 who have recently given birth. Research has also shown that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
It can be overwhelming becoming a mother. Women who suffer from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to a breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at read more low levels. The rate of medication exposure will differ based on dosage, frequency of administration and time of day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn isn't yet fully understood.
Due to the absence of research, some physicians may recommend stopping stimulant drugs during the pregnancy of a woman. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the risk to the embryo. In the meantime, until more information is available, doctors may ask pregnant patients whether they have a background of ADHD or if they are planning to take medication during the perinatal phase.
A increasing number of studies have revealed that the majority of women are able to safely continue to take 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 doctor they have discovered that the benefits of maintaining 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 advice prior to becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and strengthen the coping mechanisms. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration, and, if needed adjustments to the medication regime.