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ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs can affect the fetus.

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 that more high quality research is needed.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication must weigh the benefits of taking it against the potential dangers for the baby. Physicians do not have the data needed to provide clear recommendations but they can provide information on benefits and risks that can aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers used a large population-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure accurate case classification and to limit the possibility of bias.

However, the researchers' study had its limitations. The researchers were not able in the beginning, to separate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to medication use or affected by co-morbidities. In addition the researchers did not look at long-term offspring outcomes.

The study did show that infants whose mothers had taken ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system-related disorders, and the increased risk of admission did not appear to be influenced by the stimulant medication was used during pregnancy.

Women who used stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean birth or having a child with low Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.

The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child of continuing treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them develop coping strategies that Can General practitioners prescribe adhd Medication lessen the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is one that doctors are having to have to face. These decisions are usually made without clear and reliable evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other doctors and the research on the subject.

The issue of risk to infants is particularly tricky. The research on this subject is based on observations instead of controlled studies and many of the findings are contradictory. The majority of studies focus on live births, which may underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these shortcomings by examining data on both live and deceased births.

Conclusion Some studies have revealed an association between ADHD medications used for adhd and certain birth defects, other studies have not shown such a relationship. Most studies show an unintended, or somewhat negative, impact. Therefore an accurate risk-benefit analysis must be conducted in every situation.

It can be difficult, if not impossible for women with ADHD to stop taking their medication. 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 patients with ADHD. In addition, a decrease in medication can affect the ability to complete job-related tasks and drive safely which are essential aspects of a normal life for many people suffering from ADHD.

She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers, and their friends about the condition, its impact on daily functioning and the benefits of keeping the current treatment. Educating them can also help the woman feel supported when she is struggling with her decision. Some medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the drug may be transferred to her baby.

Birth Defects and Risk of

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about the effects that the drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers utilized two massive data sets to examine over 4.3 million pregnancy and determine if stimulant medication use increased birth defects. Researchers found that while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.

The researchers behind the study found no connection between early medication use and congenital abnormalities such as facial clefting or club foot. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who began taking ADHD medication prior to pregnancy. The risk grew during the latter part of pregnancy, as many women are forced to stop taking their ADHD medications.

Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth or have a low Apgar after birth and have a baby who needed help breathing at birth. However, the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could have contributed to these findings.

The researchers hope their study will help inform the clinical decisions of physicians who see pregnant women. The researchers advise that, while discussing benefits and risks are crucial, the decision on whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.

The authors also caution that, while stopping the medication is an option, it isn't an option to consider due to the high incidence of depression and other mental health issues among women who are pregnant or who are recently postpartum. Furthermore, research suggests that women who choose to stop taking their medications are more likely to experience a difficult time adjusting to life without them following the birth of their baby.

Nursing

It can be a challenge becoming a mother. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to new routines. As such, many women choose to continue taking their ADHD medications throughout pregnancy.

The majority of stimulant medications pass through breast milk in small amounts, therefore the risk for infant who is breastfeeding is low. The rate of medication exposure will differ based on dosage, frequency of administration and the time of the day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn isn't yet fully known.

Because of the lack of evidence, some doctors may recommend stopping stimulant medication during the pregnancy of a woman. It's a difficult choice for the woman, who must weigh the benefits of her medication against the risks to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time.

A increasing number of studies have revealed that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are choosing to do so. They have concluded after consulting with their doctors that the benefits of keeping their current medication outweigh possible risks.

It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD recognize their symptoms and the underlying disorder and learn about treatment options and strengthen existing coping strategies. This should be a multidisciplinary effort together with obstetricians, GPs, and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, and monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regime.