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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. There aren't many studies on how exposure to ADHD for a long time could affect the pregnant fetus.

A study recently published in Molecular Psychiatry shows that children exposed to adhd medication options medication in utero do not develop neurological disorders like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against the potential risks to the fetus. Doctors don't have enough data to give clear advice however they can provide information about risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have a significantly increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large population-based study of case control to compare the incidence of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was correct and to reduce any bias.

However, the researchers' study was not without its flaws. The researchers were not able in the beginning to differentiate the effects of the medication from the disorder. This makes it difficult to determine whether the small differences observed in the exposed groups are due to the use of medication or the confounding effect of comorbidities. Additionally, the researchers did not examine long-term offspring outcomes.

The study did find 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 infants who were born without any medication or had stopped their medications before or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy.

Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages can be offset by greater benefits for baby and mother of continued treatment for the woman’s disorder. Physicians should talk to their patients about this issue and try to help them develop coping skills that may reduce the impact of her disorder in her daily life and relationships.

Interactions with Medication

As more women than ever before are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is a question that doctors are having to have to face. The majority of these decisions are taken in the absence of any evidence that is clear and definitive regardless, so doctors have to weigh their experience from their own experiences, those of other doctors, and what the research suggests on the subject and their own judgments for each patient.

Particularly, the subject of potential risks for the infant can be difficult. The research on this issue is based on observation rather than controlled studies and many of the findings are conflicting. The majority of studies limit their analysis to live births, which can underestimate the teratogenic impact that can lead to terminations or abortions types of adhd Medication pregnancy. The study discussed in the journal club addresses these shortcomings by analyzing the data from deceased and live births.

Conclusion Some studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies show an unintended, or slight negative impact. Therefore, a careful risk/benefit analysis must be done in each instance.

For women suffering from ADHD who suffer from ADHD, the decision to stop taking medication can be difficult, if not impossible. In an article published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping adult adhd medication uk medication during pregnancy can increase depression, feelings of loneliness, and family conflict for these patients. Additionally, the loss of medication can interfere with the ability to do jobs and drive safely, which are important aspects of daily life for a lot of people with ADHD.

She suggests that women who are unsure about whether to continue or stop taking medication because of their pregnancy, consider informing family members, friends, and coworkers on the condition, its impact on daily functioning, and on the benefits of keeping the current treatment plan. It can also help women feel confident about her decision. Certain medications can be passed through the placenta. If a woman decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be transferred to the baby.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing, so does concern about the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers utilized two massive data sets to examine over 4.3 million pregnant women and determine whether stimulant medications caused birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medicines was associated with an increased risk of certain heart defects, such as ventriculoseptal defect (VSD).

The researchers behind the study found no connection between early use of medication 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 among women who began taking ADHD medications prior to the time of the birth of their child. The risk was higher in the latter half of pregnancy, when many women are forced to stop taking their ADHD medication.

Women who took ADHD medication during the first trimester were more likely require a caesarean birth and also have a low Apgar after delivery, and have a baby that needed breathing assistance after birth. The authors of the study were not able to remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings.

Researchers hope their research will provide doctors with information when they meet pregnant women. They advise that while 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.

human-givens-institute-logo.pngThe authors warn that, while stopping the medication is an option to consider, it is not advised due to the high rate depression and mental health issues among women who are pregnant or recently gave birth. Furthermore, research suggests that women who choose to stop taking their medications are more likely to experience difficulties adjusting to life without them following the birth of their baby.

Nursing

The responsibilities of a new mother can be overwhelming. Women with ADHD who have to deal with their symptoms while attending physician appointments as well as making preparations for the arrival of a child and adjusting to new household routines can experience severe challenges. Many women choose to continue taking their safest adhd medication medication during pregnancy.

The majority of stimulant medications are absorbed by breast milk in small quantities, so the risk for infant who is breastfeeding is low. However, the amount of exposure to medications by the infant can differ based on dosage, how often it is administered, and at what time it is administered. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The impact of these medications on a newborn's health is not completely understood.

coe-2022.pngBecause of the lack of research, some physicians may recommend stopping stimulant medication during a woman's pregnancy. This is a complicated decision for the patient, who must balance the benefits of continuing her medication with the potential risks to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time.

A growing number of studies have shown that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are opting to do so. They have concluded through consultation with their doctor, that the benefits of keeping their current medication outweigh any potential risks.

Women with best adhd medication for someone with anxiety who are planning to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD be aware of their symptoms and underlying disorder and learn about treatment options and reinforce existing strategies for managing. This should be a multidisciplinary effort with the GPs, obstetricians, and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, monitoring of signs of deterioration and, if needed adjustments to the medication regime.
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