The History Of ADHD Medication Pregnancy
The History Of ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during pregnancy and breastfeeding is challenging for women with the condition. There aren't many studies regarding how exposure over time may affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the advantages of using them against the risks to the fetus. Physicians do not have the information needed to provide clear recommendations however they can provide information about benefits and risks that can aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers used a large population-based study of case control to examine the prevalence of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was correct and to eliminate any bias.
However, the researchers' study had its limitations. Most important, they were unable to distinguish the effects of the medication from the effects of the disorder at hand. This makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of medications or affected by comorbidities. Additionally the study did not examine the long-term outcomes of offspring.
The study showed that infants whose mother had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a child with a low Apgar score (less than 7). These increases did not appear 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 early pregnancy could be offset by the greater benefit to both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this issue and try to help them develop coping skills that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of clear and authoritative evidence either way, so physicians must weigh their knowledge, the experiences of other doctors, and what research suggests about the subject and their own best judgment for each individual patient.
Particularly, the issue of potential risks to the infant can be difficult. The research on this subject is based on observations rather than controlled studies, and many of the findings are contradictory. The majority of studies restrict their analysis to live births, which may underestimate the teratogenic impact that can lead to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing both information on deceased and live births.
The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative impact. Therefore, a careful risk/benefit analysis must be conducted in every instance.
It can be difficult, if not impossible, for women with ADHD to stop taking their medication. 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. Furthermore, a loss of medication may affect the ability to complete job-related more info tasks and drive safely that are crucial aspects of a normal life for a lot of people with ADHD.
She suggests women who are unsure about whether to keep or stop taking medication because of their pregnancy, consider educating family members, friends and colleagues about the condition, its effects on daily functioning, and on the advantages of staying on the current treatment regimen. It can also make the woman feel more comfortable in her struggle with her decision. Certain medications can be passed through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be transferred to the infant.
Birth Defects and Risk of
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the potential effects of these drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two huge datasets to analyze more than 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The researchers of the study could not discover any link between early use of medication and congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. The risk increased in the latter part of pregnancy when a large number of women stopped taking their medication.
Women who used ADHD medication in the first trimester of pregnancy were also more likely to experience a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance at birth. The researchers of the study were unable to remove bias in selection since they limited their study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope that their study will provide doctors with information when they meet pregnant women. They advise that while the discussion of the risks and benefits is crucial, the decision to stop or maintain treatment must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors also advise that even though stopping the medication is an option, it isn't an option that is recommended due to the high incidence of depression and other mental health issues among women who are pregnant or who are recently post-partum. Additionally, the research suggests that women who decide to stop their medications are more likely to experience a difficult time adjusting to life without them following the baby's arrival.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments as well as getting ready for the arrival of a child and adjusting to new household routines may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed through breast milk in small amounts, so the risk to nursing infant is very low. The rate of medication exposure can vary depending upon the dosage and frequency of administration as well as time of day. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't well understood.
Due to the absence of research, some doctors may recommend stopping stimulant medications during the pregnancy of a woman. This is a difficult decision for the woman, who must weigh the advantages of taking her medication as well as the risks to the foetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they plan or are taking to take medication during the perinatal time.
A increasing number of studies have shown that most women can safely continue their ADHD medication during pregnancy and breastfeeding. In the end, an increasing number of patients choose to do so and, in consultation with their physician, they have discovered that the benefits of maintaining their current medication far outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help women with ADHD be aware of their symptoms and the root cause and learn about treatment options and strengthen existing strategies for coping. This should be a multidisciplinary process with the GPs, obstetricians and psychiatry. The pregnancy counselling should consist of discussion of a management plan for both the mother as well as the child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.