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A Look At The Ugly Real Truth Of ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these drugs could affect the fetus.

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 that more high-quality studies are needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication need to consider the benefits of taking it against the possible dangers for the fetus. Physicians do not have the information needed to provide clear recommendations but they can provide information about risks and benefits that help pregnant women make informed decisions.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. Researchers used a large sample-based case control study to examine the prevalence of major structural defects in infants born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to ensure that the classification was accurate and to eliminate any bias.

However, the study was not without its flaws. In particular, they were unable to separate the effects of the medication from the disorder at hand. This makes it difficult for researchers to establish whether the small differences observed between the groups that were exposed to the use of medication or if they were confounded by co-morbidities. In addition the researchers did not examine the long-term effects of offspring on their parents.

The study did reveal that infants whose mothers took ADHD medication during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.

Women who used stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean section or having a baby born with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication used during pregnancy.

The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefits to both mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, if they are able, assist them in developing strategies to improve their coping abilities that may minimize the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or end treatment during pregnancy is a question that more and more doctors have to face. Often, these decisions are made without solid and reliable evidence regardless, so doctors must weigh what they know from their own experiences, those of other doctors, and what the research suggests on the subject and their own judgments for each individual patient.

The issue of risk for infants can be particularly tricky. The research on this issue is based on observations rather than controlled studies, and the results are conflicting. Most studies restrict their analysis to live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.

The conclusion: While some studies have shown a positive association between ADHD medications and the possibility of certain birth defects, others have found no such relationship and the majority of studies demonstrate a neutral or slightly negative impact. In the end, a careful risk/benefit assessment must be done in each instance.

It can be difficult, if not impossible for women with ADHD to stop taking their medication. In fact, in an article recently published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation and family conflict for patients with ADHD. In addition, a decrease in medication can interfere with the ability to perform job-related tasks and drive safely that are crucial aspects of a normal life for many people suffering from ADHD.

She recommends women who are unsure about whether or not to stop taking medication because of their pregnancy consider educating family members, friends and colleagues about the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. It will also help a woman feel supported in her decision. Certain medications can pass through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be transferred to the baby.

Birth Defects and Risk of

As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on foetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two huge data sets to examine more than 4.3 million pregnant women and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication use was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.

The researchers of the study did not discover any connection between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are consistent with previous studies showing the presence of a small, but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications before the birth of their child. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication.

Women who used ADHD medication in the first trimester of pregnancy were also more likely to experience caesarean section, low Apgar score after delivery and a baby who needed help breathing at birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical conditions that could have contributed to the findings.

The researchers hope that their research will help inform the clinical decisions of doctors who see pregnant women. The researchers suggest that while discussing benefits and risks are important, the choice on whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her requirements.

The authors also caution that even though stopping the medication is an alternative, it is not an option to consider due to the high rate of depression and other mental health problems among women who are pregnant or postpartum. Furthermore, research suggests that women who choose to stop taking their medication are more likely to experience a difficult time adjusting to life without them following the birth of their baby.


Nursing

The responsibilities of a new mom can be overwhelming. Women with ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to new routines. Therefore, best adhd medication for adults uk decide to continue taking their ADHD medications throughout pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at low levels. However, the amount of medication exposure to the newborn can vary depending on the dosage, frequency it is administered and the time of day the medication is administered. In addition, various drugs enter the infant's system through the gastrointestinal tract or breast milk. The impact on the health of a newborn isn't fully comprehended.

Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult decision for the patient, who must balance the benefits of continuing her medication with the potential risks to the fetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal period.

Numerous studies have proven that women can continue to take their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are opting to do so. They have discovered, in consultation with their doctor, that the benefits of continuing their current medication far outweigh any risk.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both mother and child, and monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.

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