15 Latest Trends And Trends In ADHD Medication Pregnancy
ADHD Medication During Pregnancy and BreastfeedingWomen suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There are few data regarding how exposure over time may affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the potential dangers for the foetus. Physicians don't have the information needed to provide clear recommendations however they can provide information regarding risks and benefits that aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast, population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was accurate and to minimize any bias.
However, the study was not without its flaws. The researchers were not able, in the first place, to separate the effects caused by the medication from the disorder. This makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to medication use or confounding by comorbidities. In addition, the researchers did not study the long-term effects of offspring on their parents.
The study showed that infants whose mother had taken ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not use any medication during pregnancy or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk for admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases didn't seem to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit to both mother and child from continued treatment for the woman's condition. Physicians should speak with their patients about this and as much as possible, assist them develop coping strategies that could reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether or not to end treatment during pregnancy is a question that more and more doctors have to face. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must consider their own expertise, the experience of other physicians and the research that has been conducted on the subject.
The issue of possible risks to the infant can be difficult to determine. A lot of studies on this subject are based on observational evidence instead of controlled research and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which may underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study presented in the journal club addresses these shortcomings by analyzing information on deceased and live births.
The conclusion The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no such relationship, and most studies have a neutral or slightly negative effect. As a result an accurate risk-benefit analysis is required in every instance.
For many women with ADHD, the decision website to stop medication is difficult, if not impossible. In an article published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness and family conflict for these patients. Additionally, the loss of medication can interfere with the ability to do job-related tasks and drive safely, which are important aspects of a normal life for many people with ADHD.
She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy educate family members, coworkers, and friends about the condition, its effects on daily functioning, and the advantages of staying on the current treatment. It can also help women feel supported in her decision. Some medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the drug could be passed on 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 the concern over the potential adverse effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. Researchers used two massive data sets to examine more than 4.3 million pregnant women and determine if stimulant medication use caused birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects, like ventriculo-septal defects (VSD).
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 the same vein as previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the birth of their child. This risk increased during the latter half of pregnancy when many women decided to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean birth, have a low Apgar after delivery and have a baby that needed help breathing at birth. The authors of the study could not eliminate selection bias because they limited the study to women with no other medical conditions that might have contributed to the findings.
The researchers hope that their research will aid in the clinical decisions of physicians who treat pregnant women. The researchers suggest that, while discussing benefits and risks are crucial, the decision about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also caution that, while stopping the medication is an alternative, it is not a recommended practice because of the high incidence of depression and other mental health problems for women who are expecting or post-partum. Research has also shown that women who stop taking their medications will have a harder time adjusting to a life without them after the baby is born.
Nursing
It can be a challenge to become a mom. Women with ADHD who have to manage their symptoms while attending physician appointments, preparing for the arrival of a baby and getting used to new routines at home may face a lot of challenges. Therefore, many women decide to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed by breast milk in very small amounts, so the risk for nursing infant is very low. The amount of exposure to medications will vary based on the dosage the medication is administered, its frequency and the time of the day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not fully known.
Due to the absence of evidence, some doctors may be inclined to discontinue stimulant medication during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the potential dangers to the foetus. Until more information becomes available, doctors may inquire about pregnant patients if they have any history of ADHD or if they are planning to take medication during the perinatal phase.
A growing number of studies have revealed that women can continue their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are opting to do this. They have discovered after consulting with their physicians, that the benefits of retaining their current medication outweigh possible risks.
Women with ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD be aware of their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of the discussion of a plan for management for both the mother and child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.