Your Worst Nightmare About ADHD Medication Pregnancy Come To Life

ADHD Medication During Pregnancy and Breastfeeding

The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There is a lack of information about how long-term exposure to these medications can affect the foetus.

A recent study 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 the need for higher-quality studies.

Risk/Benefit Analysis

Pregnant women who take ADHD medications must weigh the benefits of using them against the risks to the foetus. The doctors don't have the information to give clear advice however they can provide information on risks and benefits to assist pregnant women to make informed choices.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have an increased risk of fetal cardiac malformations or major structural birth defects. The researchers used a large, population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants during early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to limit the chance of bias.

The study of the researchers was not without its limitations. Researchers were unable in the beginning to distinguish the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to medication use or if they were confounded by the presence of comorbidities. The researchers also did not examine long-term outcomes for the offspring.

The study did reveal that babies whose mothers had taken ADHD medication during pregnancy were at slightly 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 was due to central nervous system disorders, and the increased risk for admission was not found to be affected by the type of stimulant medications were used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean section or having a child with an low Apgar score (less than 7). These increases appeared to be independent of the type of medication used during pregnancy.

Researchers suggest that the small risks posed by the use of ADHD medications in early pregnancies may be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies to improve coping skills which can reduce the negative impact of her condition on her daily life and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether or not to end treatment during pregnancy is a question that doctors are having to confront. These decisions are usually taken without clear and authoritative evidence. Instead, physicians must take into account their own experience in conjunction with the experiences of other doctors and the research on the topic.

Particularly, the subject of possible risks to the infant can be difficult. The research that has been conducted on this topic is based on observation rather than controlled studies and a lot of the results are conflicting. Most studies restrict their analysis to live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in the journal club addresses these shortcomings, by examining both information on deceased and live births.

Conclusion A few studies have shown an association between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies have shown a neutral, or even slightly negative, effect. In the end, a careful risk/benefit analysis is required in every case.

For a lot of women with ADHD, the decision to stop medication is difficult if not impossible. In a recent article in the 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 being isolated. A decrease in medication could also affect the ability to safely drive and complete work-related tasks, which are vital aspects of everyday life for those with ADHD.

She suggests that women who are unsure whether to continue taking the medication or stop due to pregnancy educate family members, coworkers and friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment regimen. Educating them can also help the woman feel supported when she is struggling with her decision. It is also worth noting that certain medications are able to pass through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the infant.

Risk of Birth Defects

As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about the effects that the medications could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers utilized two massive data sets to examine more than 4.3 million pregnancies and determine if stimulant medication use caused birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of specific heart defects like ventriculoseptal defect.

The authors of the study did not discover any link between the use of early medications and other congenital anomalies like facial deformities or club feet. The results are in line with previous studies that have shown a small, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the birth of their child. This risk increased during the latter half of pregnancy when a large number of women decided to stop taking their medication.

Women who used ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who required breathing assistance during birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who did not have any other medical issues that could be a contributing factor to these findings.

Researchers hope that their research will provide doctors with information when they see pregnant women. They advise that while the discussion of the benefits and risks is important, the decision to stop or continue medication must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors caution that, while stopping the medication is a possibility to look into, it is not advised due to the high prevalence of depression and other mental disorders for women who are pregnant or who have recently given birth. Additionally, the research suggests that women who choose to stop their medications are more likely to have difficulties getting used to life without them after the birth of their baby.

Nursing

The responsibilities of a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments and preparing for the arrival of a baby and getting used to new routines at home may face a lot of challenges. Many women opt to continue taking their ADHD medication during pregnancy.

The majority of stimulant medicines are absorbed through breast milk in very small amounts, therefore the risk for breastfeeding infant is minimal. However, the amount of exposure to medication by the newborn can vary depending on the dosage, frequency it is administered and the time of day the medication is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not well known.

Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the absence of research. This is a difficult choice for the patient, who must balance the benefits of keeping her medication against the potential risks to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they are planning or taking to take medication during the perinatal time.

Numerous studies have proven that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. In  adhd treatment without medication , many patients are choosing to do so and in consultation with their doctor they have found that the benefits of maintaining their current medication outweigh any risks.

It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and strengthen the coping mechanisms. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if necessary modifications to the medication regime.