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ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies regarding how exposure over time may affect the pregnant fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD best medication for adhd combined type during pregnancy do not develop neurological problems such as impaired hearing or 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 medication need to weigh the benefits of taking it versus the risks for the foetus. Physicians don't have the data to make unambiguous recommendations, but can provide information on 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 early pregnancy did not have a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case control study to assess the frequency of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure correct case classification and to limit the possibility of bias.

However, the study was not without its flaws. The researchers were unable to, in the first place, to separate the effects triggered by the medication from the disorder. This makes it difficult for researchers to establish whether the small associations observed among the exposed groups were due to medication use or if they were confounded by the presence of comorbidities. In addition the researchers did not look at the long-term outcomes of offspring.

The study did find that infants whose mothers took ADHD medication during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had taken off their medication prior to or during pregnancy. This increase was due to central nervous system-related disorders and the higher 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 risk of having to have an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases did not seem to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medications in early pregnancies may be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.

Interactions with Medication

As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to continue or discontinue treatment during pregnancy is one that more and more physicians have to face. These decisions are often made without clear and reliable evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors and the research that has been conducted on the subject.

The issue of potential risks for infants can be particularly tricky. Many of the studies on this issue are based on observational evidence instead of controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing both information on deceased and live births.

Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show an unintended, or slightly negative, impact. In the end, a careful risk/benefit assessment must be done in each case.

For women suffering from ADHD and ADD, the decision to stop medication is difficult if not impossible. In fact, in an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness, and family conflict for those suffering from the disorder. Additionally, the loss of medication may affect the ability to complete work-related tasks and safely drive, which are important aspects of daily life for many people with ADHD.

She recommends that women who are unsure about whether to keep or discontinue medication due to their pregnancy, consider informing family members, friends and colleagues about the condition, its effects on daily functioning, and on the advantages of continuing the current treatment regimen. It can also help a woman feel more confident in her decision. It is important to remember that some medications are able to be absorbed through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be transferred to the child.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about the effects that the drugs might have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. With two massive data sets, researchers were able to examine more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects.

The researchers behind the study found no connection between early medication use and congenital abnormalities such as facial clefting or club foot. The findings are in line with previous studies showing the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking adhd stimulant medication medications prior to the birth of their child. This risk increased during the latter part of pregnancy, when a lot of women decide to stop taking their medication.

Women who took ADHD medication during the first trimester were more likely to need a caesarean, have a low Apgar after birth and have a baby that needed breathing assistance when they were born. However, the authors of the study were unable to eliminate selection bias by limiting the study to women who did not have any other medical conditions that could be a contributing factor to these findings.

The researchers hope their research will serve to inform the clinical decisions of doctors who treat pregnant women. They suggest that although the discussion of the benefits and risks is important, the decision to stop or maintain medication should be based on the woman's needs and the severity of her ADHD symptoms.

The authors warn that, while stopping the medication is an option to think about, it isn't advised due to the high prevalence of depression and mental health issues for women who are pregnant or who have recently given birth. Further, the research suggests that women who decide to stop their medications are more likely to have a difficult time adjusting to life without them following the baby's arrival.

Nursing

It can be a stressful experience to become a mom. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments and making preparations for the arrival of a baby and adjusting to new household routines can experience severe challenges. Many women choose to continue taking their adhd medication for adults uk medication during pregnancy.

The risk for breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at a low level. The amount of exposure to medications will vary based on the dosage the medication is administered, its frequency and the time of day. In addition, different medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The impact on a newborn's health is not fully comprehended.

Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must weigh the benefits of keeping her medication against the possible dangers to the foetus. In the meantime, until more information is available, doctors may inquire about pregnant patients if they have a background of ADHD or if they intend to take medication in the perinatal stage.

A increasing number of studies have revealed that women can continue taking their ADHD medication while they are pregnant and nursing. In the end, more and more patients are choosing to do so and in consultation with their doctor they have found 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 physician and discuss the advantages and disadvantages of continued treatment, including non medication treatment for adhd adults, opensourcebridge.Science,-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of signs of deterioration, and, if necessary modifications to the medication regime.