ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data on how exposure to ADHD for a long time could affect a pregnant fetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications need to balance the benefits of using them against the risks to the foetus. Doctors don't have the necessary data to make unequivocal recommendations but they can provide information about risks and benefits that help pregnant women make informed decisions.

A study published in Molecular Psychiatry found that women who took does adhd medication work medications in early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major 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 had taken stimulants in the early stages of pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias.

The study conducted by the researchers was not without its limitations. The most important issue was that they were unable to distinguish the effects of the medication from the underlying disorder. This limitation makes it difficult to know whether the small associations observed in the exposed groups result from medication use or comorbidities that cause confusion. Additionally, the researchers did not examine the long-term effects of offspring on their parents.

The study did find that infants whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders, and the higher risk of admission was not found to be influenced by the stimulant medication was used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases did not appear to be influenced by the kind of medication used during pregnancy.

The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them develop coping skills that may reduce the effects of her disorder on her daily functioning and her relationships.

Medication Interactions

As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to keep or end treatment during pregnancy is one that doctors are having to confront. These decisions are often made without clear and reliable evidence. Instead, doctors must weigh their own knowledge in conjunction with the experiences of other doctors and the research that has been conducted on the subject.

In particular, the issue of possible risks to the infant can be difficult. Many of the studies on this issue are based on observational data instead of controlled research and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which may undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these limitations by analyzing data on live and deceased births.

The conclusion The conclusion: While some studies have found a positive association between ADHD medications and the risk of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slight negative effect. In all cases an in-depth analysis of the risks and benefits should be conducted.

For women suffering from adhd medication pregnancy (my company) who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In fact, in an article published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness and family conflict for these patients. A loss of medication may also affect the ability to safely drive and complete work-related tasks, which are essential aspects of normal life for those with ADHD.

She recommends women who are unsure about whether to continue or stop medication in light of their pregnancy, consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. It can also help the woman feel supported when she is struggling with her decision. It is also worth noting that certain medications are able to pass through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the infant.

Birth Defects and Risk of

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 foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. With two massive data sets researchers were able to look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.

The researchers behind the study found no connection between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in line with previous studies that have shown a small, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before the birth of their child. The risk was higher in the later part of pregnancy, when a lot of women are forced to stop taking their medication.

Women who used ADHD medications used to treat adhd during 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. The authors of the study were unable to eliminate selection bias because they restricted the study to women without other medical conditions that might have contributed to the findings.

The researchers hope their study will help inform the clinical decisions of doctors who treat pregnant women. They recommend that, while discussing risks and benefits is important however, the decision to stop or continue treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors also warn that even though stopping the medication is an option, it isn't an option that is recommended due to the high incidence of depression and other mental health problems in women who are pregnant or recently postpartum. Further, the research suggests that women who choose to stop taking their medication are more likely to have a difficult time adjusting to life without them after the baby's arrival.

Nursing

The responsibilities of being a new mother can be overwhelming. Women with ADHD are often faced with a number of difficulties when they have to manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant drugs pass through breast milk in low estrogen and adhd medication amounts, therefore the risk for infant who is breastfeeding is low. However, the rate of exposure to medication by the infant can differ based on the dosage, frequency it is administered and the time of the day it is administered. In addition, different medications enter the baby’s system via the gastrointestinal tract or through breast milk. The impact of these medications on a newborn's health is not fully comprehended.

Due to the absence of evidence, some doctors may recommend stopping stimulant medication during a woman's pregnancy. This is a complicated decision for the patient, who must weigh the benefit of continuing her medication against the possible dangers to the foetus. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal time.

A increasing number of studies have revealed that the majority of women are able to safely continue taking their ADHD medication during pregnancy and while breastfeeding. This has led to an increasing number of patients are choosing to do so and in consultation with their physician, they have found that the benefits of continuing their current medication far exceed any risk.

It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to 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 understand their symptoms and underlying disorder, learn about available treatment options and strengthen existing coping strategies. This should be a multidisciplinary approach together with obstetricians, GPs and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication for autism and adhd regimen.