The History Of ADHD Medication Pregnancy
The History Of ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how exposure to ADHD for a long time could affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental conditions like impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to evaluate the benefits of using it versus the risks for the fetus. Doctors don't have enough data to make unambiguous recommendations but they can provide information about risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy did not have a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case control study to compare the incidence of major structural defects in infants born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was accurate and to eliminate any bias.
The study of the researchers was not without limitations. Most important, they were unable to separate the effects of the medication from those of the underlying disorder. This limitation makes it difficult to determine whether the small differences observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. In addition, the researchers did not look at the long-term outcomes of offspring.
The study found that babies whose mothers had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy or had stopped taking their medication before or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission did not appear to be influenced by which stimulant medications were taken during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both the mother and child of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, help them develop strategies to improve their coping abilities that may minimize the impact of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether or not to stop treatment during pregnancy is one that more and more doctors confront. These decisions are often made without clear and authoritative evidence. Instead, doctors have to take into account their own experience in conjunction with the experiences of other doctors, and the research on the topic.
In particular, the issue of potential risks for the infant can be difficult. The research on this subject is based on observation rather than controlled studies and a lot of the results 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 that is discussed in this journal club addresses these limitations by analyzing data on live and deceased births.
The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no such relationship and the majority of studies demonstrate a neutral or slight negative effect. In all cases it is imperative to conduct a thorough study of the risks and benefits is required.
It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In fact, in a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness and family conflict for these patients. In addition, a decrease in medication can affect the ability to do job-related tasks and drive safely which are essential aspects of a normal life for many people with ADHD.
She recommends women who are uncertain about whether or not to stop medication in light of their pregnancy, consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily life, and the advantages of continuing the current treatment plan. Educating them can also aid in ensuring that the woman feels supported in her struggle with her decision. Certain medications can pass through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication may be transferred to her infant.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs 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 analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The researchers of the study found no link between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in agreement with previous studies that have shown an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before pregnancy. This risk increased during the latter part of pregnancy, when many women decide to stop taking their ADHD medication.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean delivery and also have a low Apgar after delivery, and had a baby that required help breathing after birth. The authors of the study were not able to eliminate bias due to selection because they limited the study to women without other medical conditions that could have contributed to the findings.
Researchers hope that their study will provide doctors with information when they encounter pregnant women. They recommend that, while discussing risks and benefits is important, the decision to stop or continue medication should be based get more info on the woman's needs and the severity of her ADHD symptoms.
The authors caution that, while stopping the medication is an option to look into, it is not recommended because of the high incidence of depression and other mental disorders in women who are expecting or recently gave birth. Additionally, research suggests that women who stop taking their medication will have a difficult time adjusting to a life without them after the baby is born.
Nursing
The responsibilities of a new mother can be overwhelming. Women suffering from ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments and 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 low quantities, so the risk to breastfeeding infant is minimal. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and time of day. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The effect on a newborn's health is not fully comprehended.
Due to the absence of evidence, some doctors might be tempted to stop taking stimulant medications during the course of pregnancy. This is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the potential risks to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they plan or are taking to take medication during the perinatal time.
Many studies have shown that women can continue to take their ADHD medication without risk during pregnancy and while breast-feeding. In the end, an increasing number of patients choose to do so, and in consultation with their doctor they have found that the benefits of maintaining their current medication outweigh any potential risks.
Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and reinforce coping mechanisms. This should involve a multidisciplinary approach with the GP, obstetricians and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both the mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.