Why The Biggest "Myths" About ADHD Medication Pregnancy May Actually Be Right

Why The Biggest "Myths" About ADHD Medication Pregnancy May Actually Be Right

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ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these medications may affect the foetus.

A study recently 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 need to evaluate the benefits of using it against the potential dangers for the fetus. Physicians do not have the information needed to make unequivocal recommendations, but they can provide information about risks and benefits that assist pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers conducted a massive population-based case control study to compare the incidence of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to limit the possibility of bias.

The study conducted by the researchers had some limitations. In particular, they were not able to differentiate the effects of the medication from the effects of the disorder that is underlying. This limitation makes it difficult for researchers to determine if the few associations observed between the groups that were exposed to medication use or if they were affected by co-morbidities. Researchers also did not examine long-term outcomes for offspring.

The study did reveal that babies whose mothers had taken ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases didn't appear to be affected by the kind 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 could 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 coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are taken in the absence of any evidence that is clear and definitive regardless, so doctors must weigh their knowledge from their own experiences, those of other doctors, and what research says on the topic as well as their own best judgment for each individual patient.

The issue of risk to infants is particularly tricky. Many of the studies on this issue are based on observations rather than controlled research and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by looking at data from both live and deceased births.

Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown that get more info there is a neutral, or somewhat negative, effect. In each case, a careful analysis of the potential risks and benefits should be conducted.

It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In an article recently 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 these patients. A loss of medication may also affect the ability to drive safely and perform work-related tasks, which are vital aspects of normal life for people with ADHD.

She suggests women who are uncertain about whether to keep or stop medication in light of their pregnancy should consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. Educating them can also aid in ensuring that the woman feels supported in her struggle with her decision. It is important to note that certain medications can pass through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the medication could be passed on to the baby.

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 medications could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. With two massive data sets researchers were able examine more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increased risk of specific heart defects, like ventriculo-septal defects (VSD).

The researchers of the study found no link between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in agreement with previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of pregnancy. This risk increased during the latter part of pregnancy when a large number of women stopped taking their medication.

Women who were taking ADHD medication during the first trimester were more likely need a caesarean and also have an insufficient Apgar after delivery, and have a baby who needed help breathing at birth. However the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have other medical issues that could have contributed to these findings.

The researchers hope that their research will help inform the clinical decisions of physicians who encounter pregnant women. They advise that while a discussion of the risks and benefits is crucial however, the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms.

The authors also warn that even though stopping the medication is an option, it isn't an option to consider due to the high rate of depression and other mental health problems in women who are pregnant or who are recently postpartum. Further, the research suggests that women who choose to stop their medications are more likely to experience difficulties adjusting to life without them after the birth of their baby.

Nursing

It can be a stressful experience becoming a mother. Women who suffer from ADHD may face a lot of challenges when they have to manage their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk in low amounts. However, the frequency of exposure to medications by the newborn may differ based on the dosage, frequency it is administered and at what time the medication is administered. Additionally, different medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The effect on the health of a newborn is not fully comprehended.

Because of the lack of research, some doctors may recommend stopping stimulant medications during the course of pregnancy. This is a difficult decision for the woman, who must weigh the benefits of continuing her medication against the risks to the foetus. As long as more information is available, GPs may inquire about pregnant patients whether they have an background of ADHD or if they are planning to take medication in the perinatal period.

A growing number of studies have revealed that women can continue their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are choosing to do so. They have concluded through consultation with their doctor that the benefits of continuing their current medication far outweigh any potential 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 review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and build coping mechanisms. This should be a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.