10 Things You Learned In Preschool, That'll Aid You In ADHD Medication Pregnancy
10 Things You Learned In Preschool, That'll Aid You In ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how exposure to ADHD for a long time could affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to weigh the benefits of taking it versus the risks for the baby. Doctors don't have the information needed to provide clear recommendations however they can provide information about the risks and benefits to assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to limit the chance of bias.
However, the researchers' study had its limitations. Most important, they were unable to distinguish the effects of the medication from those of the underlying disorder. This limitation makes it difficult for researchers to establish whether the small associations observed among the exposed groups were due to the use of medication or if they were caused by co-morbidities. The researchers did not look at long-term outcomes for the offspring.
The study did find that infants whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or stopped their medications before or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean birth or having a child with low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages may be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies to improve their coping abilities which can reduce the impact of her disorder on her daily life and relationships.
Interactions with Medication
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether or not to stop treatment during pregnancy is one that more and more physicians have to face. These decisions are often made without clear and authoritative evidence. Instead, doctors must consider their own expertise and experience, as well as the experiences of other physicians and the research on the topic.
The issue of potential risks to infants is extremely difficult. Many of the studies on this subject are based on observational data rather than controlled research and their findings are often contradictory. Most studies limit their analysis to live births, which may underestimate the teratogenic impact leading to terminations or abortions of pregnancy. The study presented in the journal club addresses these limitations, by examining both information on deceased and live births.
Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. The majority of studies show a neutral, or even slight negative effect. As a result, a careful risk/benefit analysis is required in every situation.
It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In fact, in an article 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 patients with ADHD. Furthermore, a loss of medication can affect the ability to do job-related tasks and drive safely which are essential aspects of a normal life for a lot of people with ADHD.
She suggests that women who aren't sure whether to continue taking the medication or stop due to pregnancy, educate their family members, coworkers and acquaintances about the condition, its impact on daily functioning and the benefits of keeping the current treatment regimen. It will also help a woman feel more confident in her decision. Some medications can pass through the placenta. If a patient decides to not 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 of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about the effects that the drugs might have on the fetuses. 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 look at more than 4.3 million pregnancies and see whether stimulant medication use 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 certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study could not find any association between early medication usage and congenital anomalies like facial deformities or club feet. The findings are in line with previous studies that have shown a small but significant increase in the risk of heart malformations among women who began taking ADHD medications prior to the time of pregnancy. This risk increased during the latter half of pregnancy, when a lot of women stopped taking their medication.
Women who used ADHD medications in the first trimester of pregnancy were also more likely to have caesarean section, low Apgar score after delivery and a baby that required 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 other medical issues that could have contributed to these findings.
Researchers hope their research will inform physicians when they see pregnant women. They suggest that although discussing the benefits and risks is important but the decision to stop or continue treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also warn that while discontinuing the medications is an option, it isn't an option that is recommended due to the high prevalence of depression and other mental health issues in women who are pregnant or recently post-partum. Additionally, research suggests that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women with ADHD who have to manage their symptoms while attending doctor appointments and making preparations for the arrival of a baby and getting used to new routines at home are often faced with a number of difficulties. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed by breast milk in small amounts, so the risk for breastfeeding infant is minimal. The rate of exposure to medication will vary based on the dosage and frequency of administration as well as the time of the day. Additionally, different medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not fully understood.
Due to the absence of evidence, some doctors may recommend stopping stimulant medication during the pregnancy of a woman. It's a difficult choice for the mother, who must weigh the advantages of continuing her medication against the risks to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and whether they are planning or taking to take medication during the perinatal time.
A growing number of studies have shown that the majority of women are able to safely read more continue to take their ADHD medication while they are pregnant and nursing. As a result, many patients choose to do so and, in consultation with their physician, they have discovered that the benefits of keeping their current medication outweigh any 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 pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder, learn about available treatment options and reinforce existing strategies for managing. This should be a multidisciplinary process together with obstetricians, GPs and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration and, if needed adjustments to the medication regimen.