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 regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how long-term exposure may affect a foetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must weigh the benefits of taking it against the potential risks for the baby. Physicians don't have the data to make unambiguous recommendations but they can provide information about risks and benefits to help pregnant women make an informed decision.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large population-based study of case-control to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure accurate case classification and to minimize the chance of bias.
However, the researchers' study had its limitations. The researchers were not able in the beginning, to separate the effects caused by the medication from the disorder. This limitation makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or comorbidities that cause confusion. Additionally the study did not examine the long-term effects of offspring on their parents.
The study revealed that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) as compared to those whose mothers did not take any medication during pregnancy or had discontinued taking their 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 took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean section or having a child with an low Apgar score (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy.
The researchers suggest 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 for both mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies for improving their coping skills that can lessen the effects of her disorder on her daily life and relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must weigh their own knowledge in conjunction with the experiences of other doctors and the research on the subject.
Particularly, the subject of potential risks to the baby can be tricky. Many of the studies on this issue are based on observational evidence rather than controlled research, and their conclusions are often contradictory. The majority of studies focus on live births, which can underestimate the teratogenic impact that can lead to abortions or terminations of pregnancy. The study discussed in this journal club addresses these limitations by looking at data from both live and deceased births.
The conclusion The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have found no connection and the majority of studies show a neutral or even slight negative effect. In all cases an in-depth analysis of the potential risks and benefits is required.
For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In a recent article published 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 loneliness. Furthermore, a loss of medication can affect the ability to do work-related tasks and safely drive, which are important aspects of a normal life for many people with ADHD.
She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy consider informing family members, friends and colleagues on the condition, its impact on daily functioning, and on the advantages of staying on the current treatment regimen. It can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to note that certain drugs can pass through the placenta, so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the infant.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these medications could have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. With two massive data sets researchers were able examine more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect.
The authors of the study didn't discover any connection between early medication usage and other congenital anomalies like facial deformities, or club feet. The results are consistent with previous studies showing an increase, but not significant, in the risk of heart malformations in women who started taking ADHD medications prior to the birth of their child. The risk increased in the latter part of pregnancy when many women stopped taking their medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean birth, have an insufficient Apgar after delivery, and have a baby that needed breathing assistance when they were born. The authors of the study were unable to remove bias in selection since they limited their study to women with no other medical conditions that might have contributed to the findings.
Researchers hope that their study will inform physicians when they meet pregnant women. They suggest that although a discussion of risks and benefits is important but the decision to stop or maintain medication must be based on each woman's needs and the severity of her ADHD symptoms.
The authors warn that, while stopping the medication is a possibility to look into, it is not recommended due to the high prevalence of depression and mental health issues among women who are pregnant or who have recently given birth. more info Further, the research suggests that women who decide to stop their medications are more likely to have difficulties getting used to life without them following the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women with ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to new routines. As such, many women decide to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medications pass through breast milk in very small amounts, so the risk to the breastfeeding infant is minimal. However, the amount of exposure to medications by the newborn may differ based on dosage, how often it is taken and the time of the day it 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 completely understood.
Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. It is a difficult decision for the woman, who must weigh the advantages of her medication against the risk to the embryo. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.
A growing number of studies have revealed that the majority of women are able to safely continue their ADHD medication during pregnancy and breastfeeding. This has led to more and more patients opt to do this, and in consultation with their physician, they have discovered that the benefits of continuing their current medication exceed any risk.
Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before 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 needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and build strategies for coping. This should be a multidisciplinary effort together with obstetricians, GPs, and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, monitoring of indicators of deterioration, and, if necessary, adjustments to the medication regime.