A Brief History Of ADHD Medication Pregnancy History Of ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these medications could affect the fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are required.

Risk/Benefit Analysis

Pregnant women who use ADHD medications need to balance the benefits of using them against the risks to the fetus. Doctors don't have the information needed to make unequivocal recommendations but they can provide information on benefits and risks that can help pregnant women make informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. The researchers used a large, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate case classification and to minimize the chance of bias.

The study conducted by the researchers was not without limitations. The researchers were unable in the beginning to distinguish the effects triggered by the medication from the disorder. This limitation makes it difficult to determine whether the small associations observed in the groups that were exposed are due to medication use or comorbidities that cause confusion. Researchers also did not study long-term outcomes for the offspring.

The study did show that babies whose mothers had taken ADHD medications during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had cut back on their medications prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These risks did not seem to be influenced by the kind of medication used during pregnancy.

The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both mother and child of continued treatment for the woman's disorder. Physicians should talk to their patients about this issue and, if possible, help them improve coping skills which could reduce the effects of her disorder on her daily functioning and her relationships.

Medication Interactions

Many doctors are confronted with the dilemma of whether to maintain treatment or stop as more women are diagnosed with ADHD. These decisions are often made without clear and reliable evidence. Instead, doctors have to consider their own expertise, the experience of other doctors, and the research on the topic.

In particular, the issue of possible risks to the baby can be a challenge. Many studies on this issue are based on observational data rather than controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which could underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these shortcomings, by examining both data on live and deceased births.

The conclusion The conclusion: While some studies have shown a positive association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies have a neutral or slightly negative effect. In each case, a careful analysis of the potential risks and benefits is required.

It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In a recent article published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of loneliness. A loss of medication may also impact the ability to safely drive and complete work-related tasks, which are vital aspects of normal life for those with ADHD.

She suggests women who are uncertain about whether or not to stop taking medication because of their pregnancy should consider informing family members, friends, and coworkers on the condition, its impact on daily functioning, and on the advantages of continuing the current treatment regimen. It can also make the woman feel more comfortable as she struggles with her decision. It is important to note that certain drugs can pass through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug can be transferred to the child.

Risk of Birth Defects

As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as does the concern about the potential effects of these drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Using two massive 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 medication exposure was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The authors of the study found no connection between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in line with previous studies that have shown an increase, but not significant, in the risk of cardiac malformations among women who began taking ADHD medications before the birth of their child. This risk increased during the latter part of pregnancy when many women stopped taking their medication.

Women who took ADHD medications during the first trimester of their pregnancy were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who required help breathing at birth. The researchers of the study were not able to eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings.

The researchers hope their study will aid in the clinical decisions of physicians who treat pregnant women. The researchers suggest that while discussing benefits and risks are important, the decision regarding whether or not to stop medication should be made based on the severity of each woman's ADHD symptoms and her needs.

The authors also advise that even though stopping the medication is an option, it isn't an option to consider due to the high prevalence of depression and other mental health problems in women who are pregnant or who are recently postpartum. Additionally, the research suggests that women who choose to stop their medications are more likely to experience a difficult time adapting to life without them following the baby's arrival.

Nursing

The responsibilities of a new mother can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments and making preparations for the arrival of a baby and adjusting to new household routines may face a lot of challenges. Many women choose to continue taking their ADHD medication during pregnancy.

The risk to nursing infant is low because the majority of stimulant medication is absorbed through breast milk at low levels. However, the frequency of medication exposure to the newborn can vary depending on dosage, frequency it is administered and at what time the medication is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not fully understood.

Due to the absence of research, some physicians may be inclined to discontinue stimulant medication during a woman's pregnancy. It's a difficult choice for the woman, 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 inquire with all pregnant patients about their experience with 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 their ADHD medication during pregnancy and while breastfeeding. As a result, many patients choose to do so and, after consulting with their doctor, they have found that the benefits of keeping their current medication far exceed any risk.

Women with ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before 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 here required to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and reinforce coping mechanisms. This should include a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include the discussion of a plan for management for both mother and child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.