ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is challenging for women with the condition. There aren’t enough data regarding how exposure over time may affect the fetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.

Risk/Benefit Analysis

Pregnant women who use ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians do not have the data needed to make unequivocal recommendations however they can doctors prescribe adhd medication provide information about benefits and risks that can help pregnant women make informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at a greater risk of fetal malformations or structural birth defects. The researchers used a large population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during early pregnancy, as well as those who had not. Pediatric cardiologists, clinical geneticists and other experts looked best over the counter adhd medication for adults the cases to make sure that the classification was correct and to minimize any bias.

The study Types of adhd Medication the researchers had some limitations. Researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. This makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. Additionally, the researchers did not examine long-term offspring outcomes.

The study did reveal that infants whose mothers took 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. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean section or having a baby born with a low Apgar score (less than 7). These increases didn’t appear to be affected by the type of medication that was used during pregnancy.

Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies may be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman’s disorder. Physicians should speak with their patients about this issue and as much as possible, assist them improve coping skills which could reduce the effects of her disorder on her daily life and relationships.

Medication Interactions

As more women than ever are being diagnosed with ADHD and treated with medication, the question of whether or not to discontinue treatment during pregnancy is one that more and more doctors face. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors must weigh their knowledge, the experiences of other doctors, and what research says on the topic as well as their own judgments for each patient.

The issue of possible risks to infants is particularly tricky. A lot of studies on this subject are based on observations rather than controlled research, and their conclusions are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these issues by analyzing both the data from deceased and live births.

Conclusion: While some studies have shown an association between adhd medication how does it work medications and certain birth defects however, other studies haven’t shown such a relationship. The majority of studies show a neutral, or even somewhat negative, impact. In every case, a careful study of the potential risks and benefits should be conducted.

For a lot of women with ADHD who suffer from ADHD, the decision to stop taking medication is difficult if not impossible. In a recent piece published in the Archives of Women’s Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of being isolated. In addition, a decrease in medication may affect the ability to complete job-related tasks and drive safely, which are important aspects of a normal life for many people with ADHD.

She suggests that women who are unsure about whether to keep or stop taking medication because of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment plan. Educating them can also make the woman feel more comfortable when she is struggling with her decision. Some medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it’s important to be aware that the medication could be passed on to her infant.

Risk of Birth Defects

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns over the impact that these drugs could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. Using two massive data sets researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.

The authors of the study didn’t discover any link between early use of medication and congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies which showed a small, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of pregnancy. The risk increased in the latter stages of pregnancy when many women began to stop taking their medication.

Women who were taking ADHD medication during the first trimester were more likely to need a caesarean and also have a low Apgar after delivery, and have a baby that needed breathing assistance at birth. The authors of the study were not able to remove bias in selection since they limited their study to women who did not have any other medical conditions that could have contributed to the findings.

The researchers hope their research will aid in the clinical decisions of physicians who see pregnant women. They suggest that although discussing the benefits and risks is important, the decision to stop or keep medication must be based on each woman’s requirements and the severity of her ADHD symptoms.

The authors caution that, even though stopping the medication is an option to consider, it is not recommended due to the high rate depression and mental health issues among women who are pregnant or have recently given birth. Additionally, research suggests that women who stop taking their medication will have a tough time adjusting to a life without them once the baby is born.

Nursing

It can be a challenge to become a mother. Women who suffer from ADHD who must work through their symptoms while attending physician appointments, getting ready for the arrival of a child and adjusting to new household routines may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.

The risk for nursing infant is low because the majority of stimulant medications passes through breast milk in low amounts. The rate of exposure to medication will vary based on the dosage and frequency of administration as well as the time of day. Additionally, different medications enter the baby’s system through the gastrointestinal tract or through breast milk. The impact of these medications on the health of a newborn isn’t completely known.

Due to the absence of research, some doctors may recommend stopping stimulant medications during the course of pregnancy. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication against the possible risks to the fetus. In the meantime, until more information is available, GPs can inquire about pregnant patients whether they have an background of ADHD or if they plan to take medication during the perinatal phase.

A increasing number of studies have proven that the majority of women are able to safely continue to take their ADHD medication during pregnancy and breastfeeding. In response, a rising number of patients are choosing to do this. They have found after consulting with their physicians that the benefits of retaining their current medication outweigh any potential risks.

Women with ADHD who are planning to nurse should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be informed about treatment options and strengthen coping mechanisms. This should include a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include discussion of a management plan for both the mother and child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.