10 Things You've Learned About Preschool That'll Help You Understand ADHD Medication Pregnancy
10 Things You've Learned About Preschool That'll Help You Understand 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 breastfeeding. Little data exists about how long-term exposure to these medications could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological disorders like hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians don't have the data to provide clear recommendations but they can provide information on the risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. Researchers used a large sample-based case control study to assess the frequency of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was correct and to minimize any bias.
However, the researchers' study was not without its flaws. The researchers were unable to, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult to know whether the small associations observed in the groups that were exposed result from medication use or the confounding effect of comorbidities. In addition, the researchers did not study the long-term outcomes of offspring.
The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or stopped their medications before or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy.
Researchers suggest that the minor risk of using ADHD medications in early pregnancies may be offset by the greater benefits for baby and mother of continued treatment for the woman's condition. Physicians should speak with their patients about this issue and as much as possible, assist them develop coping strategies that may reduce the effects of her disorder on her daily life and relationships.
Interactions with Medication
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 doctors are having to face. These decisions are frequently made without clear and reliable 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.
Particularly, the subject of potential risks for the baby can be tricky. The research on this subject is based on observations rather than controlled studies, and many of the findings are in conflict. In addition, most studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing data on live and deceased births.
The conclusion is that while certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, other studies have found no connection and the majority of studies show a neutral or even slightly negative impact. In each case, a careful analysis of the benefits and risks is required.
It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In an article published 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 those suffering from the disorder. Furthermore, a loss of medication can interfere with the ability to do jobs and drive safely that are crucial aspects of daily life for many people suffering from ADHD.
She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy should educate family members, coworkers and their friends about the condition, the effects on daily functioning, and the benefits of keeping the current treatment. In addition, educating them can aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can be passed through the placenta. If a patient decides not to take her ADHD medication while breastfeeding, it is crucial to be aware that the medication may be transferred to her infant.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Researchers used two huge data sets to examine over 4.3 million pregnancy and determine whether stimulant medications caused birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The researchers of the study found no association between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies that showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to pregnancy. This risk increased during the latter half of pregnancy when a large number of women decided to stop taking their medication.
Women who took ADHD medications during the first trimester of their pregnancy were also more likely to experience caesarean sections, a low Apgar score after delivery and a baby that required breathing assistance during birth. The researchers of the study could not eliminate selection bias because they limited the study to women who did not have any other medical conditions that could have contributed to the findings.
Researchers hope that their research will help doctors when they see pregnant women. The researchers advise that, while discussing risks and benefits are important, the choice about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her requirements.
The authors warn that, even though stopping the medication is a possibility to look into, it is not advised due to the high rate depression and other mental problems for women who are pregnant or who have recently given birth. Additionally, research suggests that women who stop taking their medication will have a difficult transitioning to life without them once the baby is born.
Nursing
It can be a stressful experience to become a mother. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments and getting ready for the arrival of a baby and adapting to new routines in the home can experience severe challenges. Therefore, many women decide to continue taking their ADHD medications more info throughout pregnancy.
The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk in low amounts. However, the rate of exposure to medication by the newborn may differ based on the dosage, frequency it is taken and at what time the medication is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not fully understood.
Due to the absence of research, some doctors may be inclined to discontinue stimulant medication during the course of pregnancy. This is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the potential risks to the fetus. Until more information becomes available, GPs can ask pregnant patients if they have any history of ADHD or if they intend to take medication during the perinatal stage.
Numerous studies have demonstrated that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. This has led to an increasing number of patients choose to do so and, after consulting with their doctor, they have found that the benefits of maintaining their current medication outweigh any potential risks.
It is crucial for women suffering from ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should include a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of the discussion of a plan for management for both the mother as well as the child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.