Ten Things You Need To Be Educated About ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medications during pregnancy and nursing is a challenge for women suffering from the condition. There is a lack of information about how long-term exposure to these drugs 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 more high-quality research is needed.

Risk/Benefit Analysis

Pregnant women who use ADHD medications need to balance the advantages of using them against the risks to the foetus. Physicians do not have the information needed to provide clear recommendations, but they can provide information on benefits and risks that can aid pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face a significantly increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a massive population-based case control study to compare the incidence of major structural defects in infants born to mothers who were taking stimulants during pregnancy.  adhd in adults medication  and pediatric cardiologists looked over the cases to ensure an accurate case classification and to minimize the possibility of 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 the effects of the disorder at hand. This limitation makes it difficult for researchers to determine whether the few associations observed between the groups exposed were due to medication use, or if they were confounded by co-morbidities. Additionally the researchers did not look at the long-term outcomes of offspring.

The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk of admission was not found to be affected by the type of stimulant medications were taken during pregnancy.

Women who used stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These risks did not seem to be influenced by the kind of medication used during pregnancy.

Researchers suggest that the small risk of using ADHD medications in early pregnancies can be offset by greater benefits to both mother and baby of continuing treatment for the woman's condition. Physicians should discuss this with their patients and, when possible, assist them in developing strategies to improve their coping abilities which can reduce the negative impact of her condition on her daily life and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to keep or end treatment during pregnancy is a question that more and more doctors have to face. Most of the time, these decisions are made in the absence of solid and reliable evidence regardless, so doctors have to weigh their experience, the experiences of other doctors, and what the research suggests about the subject and their own judgments for each individual patient.

The issue of risk to infants is difficult to determine. The research on this issue is based on observation rather than controlled studies and the results are conflicting. Most studies limit their analysis to live births, which can underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study discussed in the journal club addresses these issues, by examining both the data from deceased and live births.

Conclusion: While some studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown that there is a neutral, or slight negative effect. As a result, a careful risk/benefit analysis is required in every case.

It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. In addition, a decrease in medication may affect the ability to perform job-related tasks and drive safely, which are important aspects of a normal life for many people suffering from ADHD.

She recommends that women who are unsure about whether to keep or discontinue medication due to their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and on the advantages of staying on the current treatment plan. It can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to remember that some medications are able to be absorbed through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be passed on to the baby.

Risk of Birth Defects

As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the potential adverse effects of the drugs on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. With two massive data sets researchers were able to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.

The researchers of the study found no association between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in the same vein as previous studies which showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of pregnancy. The risk increased in the latter stages of pregnancy when a large number of women began to stop taking their medication.

Women who were taking ADHD medication in the first trimester were more likely to require a caesarean delivery, have a low Apgar after delivery, and have a baby that needed breathing assistance at birth. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who didn't have any other medical issues that could have contributed to the findings.

Researchers hope that their study will inform physicians when they encounter pregnant women. They suggest that although the discussion of the benefits and risks is important however, the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also warn that, while 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 problems in women who are pregnant or recently post-partum. Furthermore, research suggests that women who choose to stop taking their medication are more likely to experience difficulties adjusting to life without them following the birth of their baby.

Nursing

The responsibilities that come with being a new mom can be overwhelming. Women with ADHD who have to deal with their symptoms while attending physician appointments, getting ready for the arrival of their child and adapting to new routines in the home are often faced with a number of difficulties. As such, many women decide to continue taking their ADHD medications throughout the course of pregnancy.

The risk for breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at a low level. The amount of exposure to medications will vary based on the 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. The impact of this on a newborn infant is not yet fully understood.

Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the potential risks to the embryo. In the meantime, until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal period.

Many studies have shown that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. This has led to more and more patients opt to do this, and in consultation with their physician, they have found that the benefits of continuing their current medication far outweigh any risks.

It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. 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 strengthen the coping mechanisms. This should involve a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if needed modifications to the medication regimen.