The Reason You Shouldn't Think About Improving Your ADHD Medication Pregnancy
The Reason You Shouldn't Think About Improving Your ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these drugs may affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental conditions like hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the possible risks to the fetus. Doctors don't have enough data to provide clear recommendations, but can provide information on risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure correct case classification and to limit the possibility of bias.
However, the study was not without its flaws. The researchers were not able, in the first place to distinguish the effects triggered by the medication from the disorder. This limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed result from medication use or comorbidities that cause confusion. Additionally, the researchers did not look at the long-term effects of offspring on their parents.
The study revealed that infants whose mothers took ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who didn't take any medication during pregnancy, or had stopped taking their medication before or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the minor risk of using ADHD medications in early pregnancies could be offset by the more beneficial outcomes for both baby and mother of continued treatment for the woman’s disorder. Physicians should discuss this with their patients and, if possible, help them develop strategies to improve coping skills which can reduce the impact of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to continue or stop treatment during pregnancy is one that doctors are having to have to face. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what the research suggests on the subject, along with their own judgments for each individual patient.
The issue of potential risks for infants can be extremely difficult. Many studies on this subject are based on observations rather than controlled research, and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing the data from deceased and live births.
Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies show a neutral, or even slightly negative, effect. In the end an accurate risk-benefit analysis is required in every instance.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In fact, 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 patients with ADHD. Furthermore, a loss of medication can interfere with the ability to perform work-related tasks and safely drive which are essential aspects of a normal life for many people with ADHD.
She suggests that women who are not sure whether to continue taking medication or stop due to pregnancy should educate family members, coworkers, and their friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment. It can also make the woman feel more comfortable in her struggle with her decision. Certain medications can pass through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it is crucial to be aware that the drug may be transferred to her infant.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs might have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Using two massive data sets, researchers were able to read more analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with a slightly higher rate of certain heart defects such as ventriculoseptal defect (VSD).
The researchers of the study found no association between the use of early medications and other congenital anomalies, such as facial clefting or club foot. The findings are in line with previous studies showing a small but significant increase in the risk of developing cardiac malformations among women who began taking ADHD medications prior to the time of the time of pregnancy. The risk increased in the latter half of pregnancy, when a lot of women decided to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after delivery, and have a baby who needed breathing assistance after birth. The authors of the study could not eliminate selection bias because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.
Researchers hope that their study will provide doctors with information when they meet pregnant women. The researchers recommend that while discussing risks and benefits are crucial, the decision on whether to continue or stop taking medication should be according to the severity of each woman's ADHD symptoms and her requirements.
The authors also advise that, while stopping the medication is an option, it is not an option to consider due to the high incidence of depression and other mental health issues for women who are expecting or post-partum. Additionally, research suggests that women who stop taking their medication will have a difficult transitioning to life without them after the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the frequency of exposure to medication by the newborn may differ based on the dosage, frequency it is administered and at what time it is administered. Additionally, different medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn isn't completely comprehended.
Because of the lack of research, some physicians may recommend stopping stimulant drugs during the course of pregnancy. It's a difficult choice for the mother, who must weigh the benefits of her medication against the risks 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 plan or are taking to take medication during the perinatal time.
A increasing 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 so. They have found after consulting with their physicians, that the benefits of keeping their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, as well as monitoring for signs of deterioration, and, if necessary modifications to the medication regime.