ADHD Medication Pregnancy 10 Things I'd Like To Have Known Earlier
ADHD Medication Pregnancy 10 Things I'd Like To Have Known Earlier
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications 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 drugs could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders such as impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of taking them against potential risks to the foetus. The doctors don't have the information to provide clear recommendations, but can provide information on risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a massive population-based study of case control to examine the prevalence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias.
However, the researchers' study was not without its flaws. The most important issue was that they were not able to differentiate the effects of the medication from those of the underlying disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the groups exposed were due to medication use or if they were affected by comorbidities. The researchers did not look at the long-term effects for the offspring.
The study found that infants whose mother had taken ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not take any medication during pregnancy or stopped taking their medication before or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk of admission was not found to be influenced by the stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases appear to be independent of the type of medication used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both the mother and child of continued treatment for the woman's disorder. Doctors should discuss with their patients about this issue and, if possible, help them develop coping skills that may reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the dilemma of whether or not to discontinue treatment during pregnancy is one that doctors are having to face. The majority of these decisions are taken in the absence of clear and authoritative evidence in either case, which means that doctors must weigh what they know about their experiences, the experiences of other doctors, and what research suggests about the subject, along with their best judgment for each patient.
Particularly, the subject of possible risks to the baby can be tricky. A lot of studies on this subject are based on observational evidence rather than controlled research, and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues by analyzing both information on deceased and live births.
The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative effect. In the end, a careful risk/benefit analysis must be conducted in every instance.
For women suffering from ADHD and ADD, the decision to stop taking medication can be difficult, if not impossible. In a recent article in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation and family conflict for these patients. In addition, a decrease in medication can affect the ability to perform work-related tasks and safely drive which are essential aspects of daily life for many people suffering from ADHD.
She recommends that women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. Educating them can also help the woman feel supported when she is struggling with her decision. It is important to note that certain medications can pass through the placenta, so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug can be transferred to the child.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. With two massive data sets researchers were able look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of specific heart defects, like ventriculo-septal defects (VSD).
The researchers of the study could not discover any link between the use of early medications and other congenital anomalies, like facial deformities, or club feet. The results are in the same vein as previous studies that showed an insignificant, but small 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 part of pregnancy, when a lot of women begin to discontinue their ADHD medication.
Women who used ADHD medications in the first trimester of pregnancy were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby who needed breathing assistance during birth. However, the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could have contributed to the findings.
Researchers hope their research will inform physicians when they see pregnant women. The researchers advise that while discussing benefits and risks are crucial, the decision regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and her needs.
The authors warn that, although stopping the medication is a possibility to consider, it is not advised because of the high incidence of depression and other mental disorders for women who are pregnant or recently gave birth. Further, research shows that women who stop taking their medications will have a difficult transitioning to life without them after the baby is born.
Nursing
The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments as well as preparing for the arrival of a baby and adjusting to new household routines can experience severe challenges. As such, many women choose to continue taking their ADHD medication throughout the pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk at a low level. However, the amount of exposure to medication by the newborn may differ based on dosage, how read more often it is administered and the time of day the medication is administered. In addition, 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 isn't yet fully known.
Because of the lack of research, some doctors may be inclined to discontinue stimulant medications during the pregnancy of a woman. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication with the potential dangers to the fetus. Until more information becomes available, doctors may ask pregnant patients whether they have a history of ADHD or if they intend to take medication in the perinatal stage.
Numerous studies have proven that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. As a result, more and more patients choose to do so and in consultation with their physician, they have discovered that the benefits of maintaining their current medication exceed any risk.
Women who suffer from 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 the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and build coping mechanisms. This should be an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if necessary modifications to the medication regime.