20 Myths About ADHD Medication Pregnancy: Dispelled
20 Myths About ADHD Medication Pregnancy: Dispelled
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these drugs may affect the foetus.
A recent study 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 more high-quality studies are needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians don't have the data needed to give clear guidelines, but they can provide information on benefits and risks that can aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy did not have a greater 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 babies born to mothers who took stimulants during early pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to minimize the chance of bias.
However, the study was not without its flaws. The most important issue was that they were unable to distinguish the effects of the medication from the disorder at hand. This limitation makes it difficult to determine whether the small differences observed in the exposed groups are due to the use of medication or the confounding effect of comorbidities. Additionally the study did not study the long-term effects of offspring on their parents.
The study did show that infants whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had stopped their medications before or during pregnancy. The reason for this was central nervous system disorders, and the increased risk for admission did not appear to be influenced by which stimulant medication was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a baby with low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies can be offset by greater benefits to both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, where they are able, assist them in developing strategies for improving their coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are often made without clear and authoritative evidence. Instead, doctors have to take into account their own experience and experience, as well as the experiences of other doctors, and the research on the topic.
Particularly, the issue of possible risks to the infant can be difficult. The research that has been conducted on this topic is based on observations 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 lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these shortcomings by looking at data from both live and deceased births.
Conclusion Some studies have found an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown that there is a neutral, or slightly negative, impact. As a result, a careful risk/benefit analysis is required in every instance.
For women suffering from ADHD and ADD, the decision to discontinue medication can be difficult, if not impossible. In a recent article published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of loneliness. Additionally, the loss of medication can affect the ability to do jobs and drive safely that are crucial aspects of daily life for a lot of people with ADHD.
She suggests that women who are unsure about whether to continue or stop medication in light of their pregnancy should consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and on the advantages of continuing the non stimulant adhd medication current treatment regimen. It can also help a woman feel more confident in her decision. It is important to remember that certain drugs can pass through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the medication could be transferred to the child.
Birth Defects and Risk of
As the use and abuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing as does the concern about the potential effects of these drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Utilizing two huge data sets researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects like ventriculo-septal defects (VSD).
The authors of the study could not discover any connection between the use of early medications and other congenital anomalies such as facial deformities or club feet. The results are in line with previous studies revealing a small but significant increase in the risk of heart malformations among women who started taking ADHD medications before pregnancy. This risk increased in the latter half of pregnancy, when many women decide to stop taking their ADHD medications.
Women who took ADHD medication in the first trimester were more likely to need a caesarean, have an insufficient Apgar after birth and had a baby that required help breathing when they were born. However the researchers of the study were unable to eliminate bias due to selection by limiting the study to women who didn't have any other medical issues that could have contributed to these findings.
The researchers hope their study will serve to inform the clinical decisions of doctors who encounter pregnant women. The researchers recommend that while discussing risks and benefits 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 the needs of the woman.
The authors also warn that, while stopping the medication is an option, it isn't an option to consider due to the high rate of depression and other mental health issues for women who are expecting or postpartum. Further, the research suggests that women who decide to stop taking their medication are more likely to have difficulties adjusting to life without them after the baby's arrival.
Nursing
The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. Therefore, many women decide to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medicines are absorbed by breast milk in very small quantities, so the risk to the breastfeeding infant is minimal. The amount of exposure to medications can vary depending upon the dosage, frequency of administration and the time of the day. In addition, various drugs enter the infant's system via the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn isn't fully comprehended.
Due to the absence of research, some physicians may be inclined to discontinue stimulant drugs during the course of pregnancy. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risk to the foetus. As long as more information is available, GPs may inquire about pregnant patients whether they have any history of ADHD or if they are planning to take medication in the perinatal phase.
A growing number of studies have revealed that women can continue to take their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are opting to continue their medication. They have discovered after consulting with their doctors that the benefits of continuing their current medication outweigh potential risks.
It is essential for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's guidance 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 required to help pregnant people with ADHD understand their symptoms and underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should involve a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include the discussion of a plan for management for both mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.