20 Trailblazers Are Leading The Way In ADHD Medication Pregnancy
20 Trailblazers Are Leading The Way In ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and nursing is challenging for women with the condition. There are few data on how long-term exposure may affect the foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the benefits of taking them against the potential risks to the foetus. Physicians don't have the data to provide clear recommendations, but can provide information about risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists examined the cases to ensure correct classification of the cases and to reduce the chance of bias.
However, the researchers' study had its limitations. The researchers were not able in the beginning, to separate the effects of the medication from the disorder. That limitation makes it difficult to know whether the small differences observed in the groups that were exposed are due to medication use or comorbidities that cause confusion. Additionally the study did not study long-term offspring outcomes.
The study did find that infants whose mothers had taken ADHD medication during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or 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 influenced by which stimulant medications were 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 low Apgar score (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits to both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this and, if possible, help them develop coping skills that could reduce the impact of her disorder in her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether to keep or end treatment during pregnancy is one that more and more doctors confront. Often, these decisions are made in the absence of solid and reliable evidence either way, so physicians have to weigh their experience from their own experiences, those of other doctors, and what the research suggests about the subject, along with their best judgment for each individual patient.
Particularly, the subject of possible risks to the baby can be tricky. The research that has been conducted on this topic is based on observations rather than controlled studies and the results are conflicting. The majority of studies focus on live births, which can underestimate the severity of teratogenic effects that can lead to terminations or abortions of 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 revealed a positive correlation between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. Most studies show an unintended, or slight negative effect. In all cases, a careful study of the risks and benefits should be conducted.
It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for these patients. A loss of medication may affect the ability to safely drive and complete work-related tasks, which are crucial aspects of everyday life for those with ADHD.
She suggests that women who aren't sure whether to continue taking the medication or stop it due to their pregnancy should educate family members, colleagues, and acquaintances about the condition, its effects on daily functioning, and the benefits of continuing the current treatment plan. It will also help a woman feel supported in her decision. It is also worth noting that certain medications are able to pass through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the infant.
Birth Defects Risk
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.
The researchers of the study didn't discover any link between early medication usage and congenital anomalies like facial deformities or club feet. The results are in line with previous studies that showed the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of the time of pregnancy. The risk grew in the later part of pregnancy, when many women are forced to stop taking their ADHD medication.
Women who took ADHD medication in the first trimester were more likely to require a caesarean birth and also have a low Apgar after delivery, and had a baby that required help breathing when they were born. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who didn't have other medical issues that could have contributed to these findings.
The researchers hope that their research will help inform the clinical decisions of doctors who treat pregnant women. The researchers suggest that while discussing benefits and risks are important, the decision about whether to continue or stop taking medication should be according to the severity of each woman's ADHD symptoms and her requirements.
The authors also warn that while discontinuing the medications is an alternative, it is not a recommended practice because of the high rate of depression and other mental health problems for women who are expecting or post-partum. Research has also shown that women who stop taking their medication will have a harder time adjusting to a life without them after the baby is born.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women with ADHD may face a lot of challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is minimal because the majority more info of stimulant medication is absorbed through breast milk in low amounts. The amount of exposure to medications will differ based on dosage, frequency of administration and the time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not fully known.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. It's a difficult choice for the woman, who must weigh the advantages of continuing her medication against the potential risks to the fetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.
Numerous studies have demonstrated that women can continue taking their ADHD medication without risk while breastfeeding and during pregnancy. This has led to many patients are choosing to do so, and after consulting with their doctor, they have found that the benefits of keeping their current medication outweigh any potential risks.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also be informed about treatment options and build strategies for coping. This should include a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Counselling for pregnancy should include discussion of a management plan for both the mother and child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.