Ten Things You Learned At Preschool That Will Help You With ADHD Medication Pregnancy
Ten Things You Learned At Preschool That Will Help You With ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications can affect the foetus.
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 further high-quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against the potential risks to the fetus. Physicians don't have the data to give clear advice however they can provide information on the risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was correct and to minimize any bias.
However, the researchers' study was not without its flaws. Most important, they were not able to differentiate the effects of the medication from those of the disorder at hand. This limitation makes it difficult to know whether the small associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. The researchers did not look at long-term outcomes for the offspring.
The study found that infants whose mother took ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to those whose mothers did not take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk for admission did not appear to be influenced by which stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean section or having a baby with low Apgar score (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 may be offset by the greater benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this and as much as possible, assist them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or discontinue treatment during pregnancy is one that more and more doctors face. These decisions are frequently taken without clear and authoritative evidence. Instead, physicians must take into account their own experience, the experience of other physicians and the research that has been conducted on the subject.
The issue of risk for infants can be particularly tricky. The research on this subject is based on observations rather than controlled studies and a lot of the results are contradictory. Most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both information on deceased and live births.
The conclusion The conclusion: While some studies have found an association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative effect. In each case an in-depth analysis of the benefits and risks is required.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent article 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 isolation. A loss of medication may also affect the ability to safely drive and complete work-related tasks, which are vital aspects of everyday life for those suffering from ADHD.
She suggests that women who aren't sure whether to continue taking medication or stop due to pregnancy educate family members, coworkers, and their friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment plan. Educating them can also make the woman feel more comfortable as she struggles with her decision. It is important to remember that some medications can pass through the placenta, so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the child.
Risk of Birth Defects
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Utilizing two huge data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The researchers behind the study found no association between the use of early medications and other congenital abnormalities, like facial clefting, or club foot. The results are consistent with previous studies revealing the presence of a small, but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean birth and also have a low Apgar after birth and had a baby that required help breathing when they were born. However the authors of the study were not able to eliminate selection bias by limiting the study to women who didn't have any other medical conditions that could have contributed to these findings.
Researchers hope that their research will inform physicians when they see pregnant women. The researchers suggest that, while discussing benefits and risks are important, the choice regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and her needs.
The authors caution that, even though stopping the medication is an option to look into, it is not advised due to the high rate depression and other mental problems in women who are expecting or recently gave birth. Research has also shown that women who stop taking their medication will have a difficult transitioning to life without them after the baby is born.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women with ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.
The majority of stimulant drugs are absorbed through breast milk in very small quantities, so the risk for infant who is breastfeeding is low. However, the frequency of medication exposure to the infant can differ based on dosage, frequency it is administered and the time of day it is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The impact on the health of a newborn isn't completely known.
Because of the lack of evidence, some doctors may recommend stopping stimulant drugs during the course of pregnancy. It's a difficult choice for the more info woman who must weigh the benefits of her medication against the risk to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether they are planning or taking to take medication during the perinatal period.
A growing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication during pregnancy and while breastfeeding. In response, a growing number of patients are opting to do this. They have found, in consultation with their physicians, that the benefits of continuing their current medication outweigh any risk.
It is essential for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and strengthen the coping mechanisms. This should include a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a plan for management for both the mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.