The 10 Scariest Things About ADHD Medication Pregnancy
The 10 Scariest Things About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. Little data exists about how long-term exposure to these medications could affect the foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication must consider the benefits of taking it against the possible risks to the fetus. Physicians don't have the data needed to provide clear recommendations however they can provide information regarding risks and benefits that 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 a higher risk of fetal malformations or structural birth defects. Researchers conducted a massive sample-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure accurate classification of the cases and to reduce the chance of bias.
However, the researchers' study was not without its flaws. Researchers were unable in the beginning to distinguish the effects caused by the medication from the disorder. That limitation makes it difficult to know whether the small differences observed in the exposed groups are due to medication use or confounding by comorbidities. In addition the study did not examine long-term offspring outcomes.
The study showed that babies whose mothers took ADHD medication during pregnancy had a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This was due to central nervous system-related disorders, and the increased risk for admission was not found to be influenced by the stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean birth or having a baby born with an low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both the mother and child from continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, help them develop strategies to improve coping skills that can lessen the impact of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the question of whether to keep or stop treatment during pregnancy is a question that doctors are having to have to face. The majority of these decisions are taken in the absence of solid and reliable evidence regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what research says on the topic, along with their own judgments for each individual patient.
The issue of potential risks for infants can be difficult to determine. The research on this issue is based on observations rather than controlled studies, and the results are conflicting. The majority of studies focus on live-births, which could underestimate the severity of teratogenic effects that can lead to terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these limitations by analyzing data on live and deceased births.
The conclusion is that while certain studies have demonstrated that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies have a neutral or slightly negative effect. As a result an accurate risk-benefit analysis is required in every case.
For women suffering from ADHD who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In a recent article 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 isolation. The loss of medication can also affect the ability to drive safely and perform work-related tasks, which are essential aspects of daily life for those suffering from ADHD.
She suggests that women who are not sure whether to continue taking the medication or discontinue it due to pregnancy should educate family members, coworkers, and their friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment. Educating them can also make the woman feel more comfortable when she is struggling with her decision. Certain medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the medication could be transferred to the baby.
Risk of Birth Defects
As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the potential adverse effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Researchers used two huge data sets to study more than 4.3 million pregnant women and determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects like ventriculo-septal defects (VSD).
The researchers behind the study found no link between early use of medication and congenital abnormalities like facial clefting, or club foot. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the time of pregnancy. This risk increased in the latter half of pregnancy, when a lot of women decide to stop taking their medication.
Women who were taking ADHD medication during the first trimester were more likely to need a caesarean, have an insufficient Apgar after delivery, and have a baby that needed breathing assistance when they were born. 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 conditions that could have contributed to these findings.
Researchers hope that their study will provide doctors with information when they meet pregnant women. They suggest that although the discussion of the risks and benefits is crucial but the decision to stop or continue medication must be based on each woman's needs and the severity of her ADHD symptoms.
The authors also advise that while discontinuing the medications is an option, it isn't a recommended practice because of the high incidence of depression and other mental health problems in women who are pregnant or who are recently post-partum. Further, the research suggests that women who decide to stop taking their medication are more likely to have 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 manage their symptoms while attending physician appointments, preparing 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 majority of stimulant drugs pass through breast milk in very small amounts, therefore the risk to the infant who is breastfeeding is low. The rate of medication exposure will differ based on dosage the medication is administered, its frequency and time of day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not well known.
Because of the lack of research, some doctors may be inclined to discontinue stimulant medications during the course of pregnancy. This is a difficult decision for the patient, who must balance the benefits of keeping her medication against the possible dangers to the fetus. As long as there is no more information, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal period.
A growing number of studies have revealed that women can continue their ADHD medication during pregnancy and while breastfeeding. In response, a growing number of patients are opting to do this. They have discovered, in consultation with their physicians that the benefits of keeping their current medication far outweigh any risk.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help pregnant people with ADHD recognize their symptoms and underlying disorder and learn about treatments and to reinforce existing strategies for managing. This should be a multidisciplinary process together with obstetricians, GPs and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of indicators website of deterioration, and, if needed, adjustments to the medication regimen.