ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medications during pregnancy and nursing is a difficult decision for women suffering from the condition. Little data exists about how long-term exposure to these drugs could affect the fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological conditions like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the benefits of using them against the risks to the foetus. Doctors don't have enough data to give clear advice however they can provide information about risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at higher 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 babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to ensure that the classification was correct and to minimize any bias.

The study conducted by the researchers was not without limitations. The researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine whether the small associations observed among the groups exposed were due to the use of medication, or if they were confounded by the presence of comorbidities. Additionally the researchers did not examine the long-term outcomes of offspring.

The study found that babies whose mothers had taken ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This increase was due to 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 likelihood of having to have a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases appear to be independent of the type of medication used during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medications in early pregnancies could be offset by the greater benefits to both mother and baby from continuing treatment for the woman’s disorder. Physicians should speak with their patients about this issue and, if possible, help them develop coping strategies that can lessen the effects of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to keep or discontinue treatment during pregnancy is one that more and more doctors face. Most of the time, these decisions are taken in the absence of clear and authoritative evidence in either case, which means that doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research says on the topic as well as their own judgments for each patient.

Particularly, the subject of possible risks to the infant can be difficult. The research that has been conducted on this topic is based on observation rather than controlled studies and many of the findings are contradictory. In addition, most effective adhd medication for adults studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing the data from deceased and live births.

The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no connection, and most studies show a neutral or even slightly negative impact. As a result, a careful risk/benefit analysis must be done in each case.

For many women with ADHD, the decision to stop medication is difficult, if not impossible. In fact, in a recent article in the 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 patients with ADHD. In addition, a decrease in medication may affect the ability to complete job-related tasks and drive safely that are crucial aspects cost of adhd medication uk daily life for a lot of people with ADHD.

She suggests that women who are not sure whether to take the medication or stop it due to their pregnancy should educate family members, coworkers, and friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment plan. It can also help women feel confident about her decision. Certain medications can pass through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be transferred to the baby.

Birth Defects and Risk of

As the use of adhd sleep medication medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns over the impact that these drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers utilized two massive data sets to study over 4.3 million pregnancies and determine if stimulant medication use increased birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medications was associated with a slightly higher rate of certain heart defects, such as ventriculoseptal defect (VSD).

The authors of the study could not discover any link between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are in line with previous studies that have shown the presence of a small, but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of pregnancy. The risk was higher in the latter half of pregnancy, when a lot of women begin to discontinue their ADHD 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 that required breathing assistance during birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could have contributed to the findings.

The researchers hope their study will serve to inform the clinical decisions of physicians who treat pregnant women. They suggest that although a discussion of risks and benefits is important however, the decision to stop or maintain medication must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors warn that, while stopping the medication is a possibility to look into, it is not recommended because of the high incidence of depression and mental health issues for women who are pregnant or have recently given birth. Further, the research suggests that women who decide to stop taking their medication are more likely to experience a difficult time adapting to life without them following the birth of their baby.

Nursing

It can be overwhelming becoming a mother. Women who suffer from ADHD may face a lot of challenges when they have to manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.

The risk for breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and the time of day. Additionally, different adhd Medications medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not fully understood.

Due to the absence of research, some doctors may recommend stopping stimulant medication during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the risk 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 plan or are taking to take medication during the perinatal time.

Numerous studies have demonstrated that women can continue to take their ADHD medication without risk during pregnancy and while breast-feeding. In response, a growing number of patients are choosing to do this. They have discovered, in consultation with their doctors that the benefits of retaining their current medication far outweigh any potential risks.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother as well as the child, monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.