10 Things You'll Need To Be Aware Of ADHD Medication Pregnancy
10 Things You'll Need To Be Aware Of ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these drugs could affect the foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Pregnant women who take ADHD medications must weigh the advantages of using them against the risks to the foetus. The doctors don't have the information to give clear advice but they can provide information on risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure an accurate case classification and to limit the chance of bias.
However, the researchers' study had its limitations. Researchers were unable in the beginning to differentiate the effects triggered by the medication from the disorder. This makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or the confounding effect of comorbidities. The researchers also did not study long-term outcomes for offspring.
The study showed that infants whose mothers took ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the increased risk of admission did not appear to be influenced by the stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit to both the mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this issue and as much as possible, assist them improve coping skills which may reduce the effects of her disorder 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 to continue or stop treatment during pregnancy is a question that more and more doctors have to face. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must consider their own expertise, the experience of other doctors, and the research on the topic.
In particular, the issue of potential risks for the baby can be a challenge. Many studies on this subject are based on observations rather than controlled research and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which may underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by looking at data from both live and deceased births.
The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative effect. Therefore, a careful risk/benefit assessment is required in every instance.
For many women with ADHD and ADD, the decision to discontinue medication is difficult, if not impossible. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. The loss of medication can affect the ability to safely drive and perform work-related tasks, which are vital aspects of daily life for people with ADHD.
She suggests that women who are unsure whether to continue taking medication or stop due to pregnancy should educate family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the benefits of keeping the current treatment regimen. It will also help a woman feel confident about her decision. Certain medications can pass through the placenta. If the patient decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be passed on to her infant.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about the effects that the drugs could have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers utilized two massive data sets to study more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medicines was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).
The authors of the study found no connection between the use of early medications and other congenital anomalies, like facial clefting, or club foot. The results are in line with previous studies that have shown a small but significant increase in the risk of heart malformations in women who started taking ADHD medications prior to pregnancy. The risk increased in the latter stages of pregnancy when a large number of women began to stop taking their medication.
Women who used ADHD medication in the first trimester of pregnancy were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who required breathing assistance during birth. However the researchers of the study were unable to eliminate selection bias 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 help doctors when they meet pregnant women. The researchers suggest that, while discussing risks and benefits are crucial, the decision about whether to continue or stop medication should be in light of the severity of each woman's ADHD symptoms and her requirements.
The authors caution that, while stopping the medication is a possibility to consider, it is not advised due to the high rate depression and mental health issues for women who are pregnant or have recently given birth. Furthermore, research suggests that women who choose to stop taking their medications are more likely to have a difficult time adapting to life without them following the baby's arrival.
Nursing
It can be a challenge becoming a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, making preparations for the arrival of their child and getting used to new routines at home are often faced with a number of difficulties. Many women choose to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. However, the frequency of exposure to medications by the infant can differ based on dosage, how often it is administered, and at what time the medication is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn infant is not yet fully understood.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman, who must weigh the benefits of taking her medication as well as the potential risks to the fetus. As long as more information is available, doctors can ask pregnant patients whether they have an background of ADHD or if they plan to take medication in the perinatal period.
Many studies have shown that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. In response, an increasing number of patients are opting to do so. They have concluded after consulting with their doctor, that the benefits of keeping their current medication outweigh any possible risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss read more their medication with their prescriber, and the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also be educated about treatment options and build strategies for coping. This should include an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.