25 Unexpected Facts About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There aren't many studies on how long-term exposure may affect a fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological disorders such as hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge that more high-quality studies are needed.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to evaluate the benefits of using it against the possible risks to the fetus. Physicians don't have the information needed to give clear guidelines, but they can provide information on risks and benefits that aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers conducted a large, population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was correct and to reduce any bias.
However, the study had its limitations. Most important, they were unable to distinguish the effects of the medication from those of the disorder that is underlying. That limitation makes it difficult to know whether the limited associations observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. Researchers also did not examine the long-term effects for the offspring.
visit link revealed that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) as compared to mothers who did not take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk for admission did not appear to be affected by the type of stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having a caesarean section or one whose baby scored low on the Apgar scale (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during 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 they are able, assist them in developing strategies to improve their coping abilities that can lessen the negative impact of her condition on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or stop treatment during pregnancy is a question that doctors are having to face. Often, these decisions are made without clear and authoritative evidence in either case, which means that doctors must weigh what they know from their own experiences, those of other doctors, and what the research suggests on the subject, along with their own judgments for each patient.
Particularly, the subject of possible risks to the infant can be difficult. The research on this subject is based on observations instead of controlled studies and a lot of the results are in conflict. Most studies limit their analysis to live-births, which could underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these shortcomings, by examining both information on deceased and live births.
Conclusion: While some studies have found an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show an unintended, or slight negative effect. Therefore an accurate risk-benefit analysis must be conducted in every case.
It can be challenging, if not impossible for women with ADHD to stop taking their medication. In a recent article published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of loneliness. A loss of medication may also impact the ability to safely drive and to perform work-related tasks which are crucial aspects of normal life for those with ADHD.
She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy, educate their family members, coworkers and acquaintances about the condition, its impact on daily functioning and the advantages of staying on the current treatment plan. It can also help the woman feel supported in her struggle with her decision. Some medications can pass through the placenta. If the patient decides not to take her ADHD medication while breastfeeding, it is important to be aware that the medication may be transferred to her baby.
Birth Defects and Risk of
As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the possible effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Using two massive data sets researchers were able analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with a slightly higher rate of certain heart defects such as ventriculoseptal defect (VSD).
The researchers of the study didn't discover any connection between early medication usage and other congenital anomalies such as facial deformities or club feet. The results are consistent with previous studies showing a small but significant increase in the risk of developing cardiac malformations among women who started taking ADHD medications prior to the time of the time of pregnancy. The risk grew in the later part of pregnancy, when a lot of women decide to stop taking their medication.
Women who used ADHD medications in the first trimester of their pregnancies were also more likely to have caesarean section, low Apgar score following delivery, and a baby who needed breathing assistance during birth. The authors of the study were unable to eliminate bias due to selection because they limited the study to women who did not have any other medical conditions that might have contributed to the findings.
Researchers hope that their research will provide doctors with information when they encounter pregnant women. The researchers suggest 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 her requirements.
The authors warn that, although stopping the medication is an option to consider, it is not advised due to the high rate depression and mental health issues for women who are pregnant or who have recently given birth. Further, the research suggests that women who choose to stop taking their medication are more likely to have difficulties adapting to life without them after the baby's arrival.
Nursing
It can be overwhelming to become a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, getting ready for the arrival of their child and adapting to new routines in the home may face a lot of challenges. Therefore, many women decide to continue taking their ADHD medications throughout pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at a low level. However, the rate of exposure to medication by the newborn may differ based on the dosage, frequency it is administered, and the time of day it is administered. Additionally, different 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 understood.
Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the lack of research. It is a difficult decision for the woman who must weigh the benefits of taking her medication as well as the risks to the fetus. As long as more information is available, doctors can inquire about pregnant patients whether they have any background of ADHD or if they are planning to take medication during the perinatal phase.
Numerous studies have demonstrated that women can continue to take their ADHD medication without risk during pregnancy and breast-feeding. As a result, more and more patients choose to do so, and in consultation with their doctor they have discovered that the benefits of keeping their current medication exceed any risk.
Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and reinforce strategies for coping. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatry. The pregnancy counselling should consist of the discussion of a plan for management for both mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.