20 Trailblazers Setting The Standard In ADHD Medication Pregnancy
20 Trailblazers Setting The Standard In ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these medications can affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the fetus. The doctors don't have the information to make unambiguous recommendations however they can provide information on risks and benefits to assist pregnant women to make informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large sample-based case control study to compare the incidence 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 classification of the cases and to reduce the chance of bias.
The study of the researchers had some limitations. The most important issue was that they were unable to distinguish the effects of the medication from the underlying disorder. This makes it difficult for researchers to establish whether the few associations observed between the groups that were exposed to medication use, or if they were confounded by comorbidities. Additionally the researchers did not study the long-term effects of offspring on their parents.
The study did show that infants whose mothers took ADHD medications during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medications in early pregnancies could be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, when they are able, assist them in developing strategies to improve their coping abilities which can reduce the impact of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to keep treatment or stop as more women are diagnosed with ADHD. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to take into account their own experience in conjunction with the experiences of other physicians and the research that has been conducted on the subject.
Particularly, the issue of potential risks to the infant can be difficult. A lot of studies on this topic are based on observational evidence rather than controlled research, and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that could cause abortion or termination of the 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, other studies have not established a link. Most studies show an unintended, or slight negative impact. Therefore, a careful risk/benefit assessment is required in every situation.
It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published 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 those suffering from the disorder. A loss of medication may also affect the ability to drive safely and complete work-related tasks, which are essential aspects of normal life for people with ADHD.
She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy consider informing family members, friends, and coworkers on the condition, its effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also help women feel more confident in her decision. Certain medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication may be transferred to her baby.
Risk of Birth Defects
As the use of ADHD medication to treat the symptoms of read more attention deficit hyperactivity disorder (ADHD) increases, so do concerns over the impact that these drugs might have on the fetuses. A study that was 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 to determine whether stimulant medication use increased the risk of birth defects. Researchers found that while the overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study found no connection between early medication use and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies that showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of the birth of their child. The risk was higher in the later part of pregnancy, when many women decide to stop taking their ADHD medications.
Women who took ADHD medications in the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score after delivery and a baby that required breathing assistance at birth. However, the authors of the study were not able to eliminate bias due to selection by restricting the study to women who did not have other medical issues that could have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of physicians who see pregnant women. The researchers suggest that, while discussing benefits and risks are important, the choice about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors also warn that even though stopping the medication is an option, it isn't an option to consider due to the high rate of depression and other mental health problems among women who are pregnant or recently postpartum. 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
It can be overwhelming to become a mom. Women with ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medications are absorbed by breast milk in low quantities, so the risk to the breastfeeding infant is minimal. The rate of medication exposure will vary based on the dosage, frequency of administration and time of day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not fully known.
Because of the lack of evidence, some doctors may recommend stopping stimulant medications during the pregnancy of a woman. It is a difficult decision for the woman, who must weigh the benefits of her medication against the risks to the embryo. As long as there is no more information, doctors should inquire with all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal period.
A growing number of studies have shown that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. As a result, many patients opt to do this, and after consulting with their doctor, they have discovered that the benefits of maintaining their current medication exceed any risk.
Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD be aware of their symptoms and underlying disorder, learn about available treatment options and reinforce existing coping strategies. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. The pregnancy counselling should consist of discussion of a management plan for both the mother as well as the child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.