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adhd medication Pregnancy Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medication during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. Little data exists about how long-term exposure to these drugs may affect the fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required.

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication need to weigh the benefits of taking it against the potential risks for the fetus. Doctors don't have the information needed to provide clear recommendations however they can provide information about the risks and benefits to assist pregnant women in making informed decisions.

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 used a vast, population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure accurate case classification and to minimize the possibility of bias.

However, the researchers' study had its limitations. The researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult to determine whether the small differences observed in the groups that were exposed are due to medication use or the confounding effect of comorbidities. Additionally the study did not examine the long-term effects of offspring on their parents.

The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy.

Women who took stimulant adhd medication names uk medication during pregnancy were also at an increased chance of having a caesarean delivery or having a baby born with a low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.

The research suggests that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits to both the mother and child of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies to improve their coping abilities that may minimize the effects of her disorder on her daily functioning and relationships.

Medication Interactions

More and more doctors are confronted with the dilemma 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, physicians must consider their own expertise, the experience of other doctors and the research on the topic.

The issue of possible risks to infants is particularly tricky. The research that has been conducted on this topic is based on observations rather than controlled studies and many of the findings are conflicting. The majority of studies restrict their analysis to live-births, which could underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these limitations by examining data on both live and deceased births.

The conclusion is that while some studies have found an association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative effect. In all cases it is imperative to conduct a thorough analysis of the benefits and risks must be performed.

For many women with ADHD, the decision to stop taking medication can be difficult, if not impossible. In a recent piece published in 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 loneliness. Additionally, the loss of medication can interfere with the ability to do work-related tasks and safely drive, which are important aspects of a normal life for many people with ADHD.

She suggests women who are unsure about whether to keep or stop taking medication because of their pregnancy, consider educating family members, friends and colleagues about the condition, its effects on daily life, and the advantages of continuing the current treatment plan. It can also help a woman feel supported in her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication may be transferred to her infant.

Birth Defects and Risk of

As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers used two massive data sets to examine more than 4.3 million pregnancies and determine if the use of stimulant medications increased birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increase in the risk of certain heart defects such as ventriculoseptal defect (VSD).

The researchers of the study could not discover any connection between early use of medication and congenital anomalies like facial deformities, or club feet. The results are consistent with previous studies showing a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to pregnancy. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication.

Women who took ADHD medications in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score after delivery and a baby who needed help breathing at birth. The authors of the study were not able to eliminate bias due to selection because they limited the study to women with no other medical conditions that might have contributed to the findings.

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

The authors also warn that while discontinuing the medications is an option, it isn't an option that is recommended due to the high rate of depression and other mental health issues among women who are pregnant or recently postpartum. Further, research shows that women who stop taking their medications will have a harder adjustment to life without them after the baby is born.

Nursing

It can be overwhelming to become a mother. Women suffering from ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.

The majority of stimulant medications are absorbed through breast milk in small quantities, so the risk to breastfeeding infant is minimal. The rate of medication exposure will vary based on 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 on a newborn's health is not completely comprehended.

Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the absence of research. It is a difficult decision for the mother, who must weigh the advantages of taking her medication as well as the risks to the fetus. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.

Numerous studies have proven that women can you get adhd medication without a diagnosis continue taking their ADHD medication safely while breastfeeding and during pregnancy. In response, an increasing number of patients are choosing to continue their medication. They have discovered, in consultation with their doctors that the benefits of keeping their current medication outweigh any possible risks.

Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons for continuing treatment. This includes non stimulant adhd medication uk-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD understand their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for managing. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if necessary adjustments to the medication regimen.