Why You Should Focus On Improving ADHD Medication Pregnancy

Why You Should Focus On Improving ADHD Medication Pregnancy

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ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There is a lack of information about how long-term exposure to these medications could affect the fetus.

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 that more high-quality studies are required.

Risk/Benefit Analysis

Pregnant women who use ADHD medications must weigh the advantages of taking them against the potential risks to the fetus. The doctors don't have the information to provide clear recommendations but they can provide information on risks and benefits to assist pregnant women to make informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who took stimulants during early pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure correct case classification and to minimize the chance of bias.

However, the study was not without its flaws. In particular, they were not able to differentiate the effects of the medication from those of the disorder at hand. This limitation makes it difficult for researchers to determine if the few associations observed between the groups that were exposed to the use of medication or confounded by the presence of comorbidities. In addition the study did not look at long-term offspring outcomes.

The study found that babies whose mothers took ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy or stopped taking their medication before 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 took stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a baby born with low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefit to both the mother and child of continued treatment for the woman's disorder. Physicians should talk to their patients about this and, if possible, help them improve coping skills which may reduce the effects of her disorder on her daily functioning and her relationships.

Interactions with Medication

As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is a question that more and more doctors confront. The majority of these decisions are made without clear and authoritative evidence regardless, so doctors must weigh what they know, the experiences of other doctors, and what the research suggests on the subject and their own best judgment for each individual patient.

The issue of possible risks to infants is particularly tricky. The research that has been conducted on this topic is based on observation rather than controlled studies, and a lot of the results are conflicting. Furthermore, most studies restrict their analysis to live births, which can underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study presented in this journal club addresses these limitations by examining data on both live and deceased births.

Conclusion: While some studies have found an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies show a neutral, or even slight negative effect. In the end an accurate risk-benefit analysis must be done in each instance.

For many women with ADHD and ADD, the decision to stop taking medication can be 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 lead to depression and feelings of being isolated. A decrease in medication could affect the ability to drive safely and complete work-related tasks, which are crucial aspects of normal life for those suffering from ADHD.

She recommends that women who are unsure about whether to keep or stop taking medication because of their pregnancy consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and on the benefits of keeping the current treatment regimen. In addition, educating them can aid in ensuring that the woman feels supported in her struggle with her decision. Some medications can pass through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug may be transferred to her baby.

Birth Defects and Risk of

As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing, so does concern about the potential effects of these drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Using two massive data sets, researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects such as ventriculoseptal defect (VSD).

The researchers of the study found no link between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are consistent with previous studies showing a small but significant increase in the risk of cardiac malformations among women who started taking ADHD medications prior to pregnancy. The risk was higher during the latter part of pregnancy, as many women decide to stop taking their ADHD medications.

Women who took ADHD medication in the first trimester of their pregnancy were also more likely to experience caesarean sections, a low Apgar score after delivery and a baby that required breathing assistance at birth. The researchers of the study could not eliminate bias due to selection because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.

The researchers hope their study will serve to inform the clinical decisions of physicians who treat pregnant women. The researchers recommend that while discussing the risks and benefits are important, the decision about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her needs.

The authors also caution that while discontinuing the medications is an option, it isn't a recommended practice because of the high prevalence of depression and other mental health problems in women who are pregnant or who are recently postpartum. Furthermore, research suggests that women who decide to stop taking their medication are more likely to experience a difficult time getting used to life without them after the birth of their baby.

Nursing

It can be a stressful experience to become a mom. Women who suffer from ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.

The risk for breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at a low level. The rate of exposure to medication will differ based on dosage and frequency of administration as well as the time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn isn't well known.

Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the woman, who must weigh the advantages of continuing her medication against the risk to the embryo. In the meantime, until more information is available, GPs can ask pregnant patients if they have a history of ADHD or if they are planning to take medication in the perinatal stage.

Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In the end, many patients are choosing to do so and, after consulting with their doctor, they have found that the benefits of maintaining their current medication far exceed any risk.

It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss the medication they are taking inattentive adhd medication with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD recognize their symptoms and the underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should include a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for indicators of deterioration, and, if needed, adjustments to the medication regime.