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Why Nobody Cares About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these drugs may affect the foetus.

A study recently 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 more high-quality research.

Risk/Benefit Analysis

Pregnant women who use ADHD medications must weigh the benefits of using them against the risks to the fetus. Physicians don't have the necessary data to give clear guidelines however they can provide information on the risks and benefits to assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers used a large population-based study of case control to assess the frequency of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was accurate and to eliminate any bias.

The study conducted by the researchers was not without limitations. The most important issue was that they were unable to distinguish the effects of the medication from the effects of the disorder that is underlying. This limitation makes it difficult for researchers to establish whether the small associations observed among the groups exposed were due to the use of medication or confounded by comorbidities. The researchers also did not study long-term outcomes for offspring.

The study did reveal that infants whose mothers took ADHD medications during pregnancy were at slightly higher 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. This increase was due to central nervous system disorders, and the increased risk for admission was not found to be influenced by which stimulant medications were taken during pregnancy.

Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These increases appear to be unrelated to 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 of continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, help them develop 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 are diagnosed with ADHD and being treated with medication, the question of whether or not to discontinue treatment during pregnancy is one that more and more doctors have to face. These decisions are often taken without clear and authoritative evidence. Instead, physicians must take into account their own experience and experience, as well as the experiences of other doctors and the research on the subject.

Particularly, the issue of potential risks to the infant can be difficult. Many studies on this topic are based on observational evidence rather than controlled research and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which can undervalue the serious teratogenic effects that can cause abortion or termination of the 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 an association between ADHD medications and the possibility of certain birth defects, other studies have found no connection, and most studies show a neutral or even slightly negative impact. As a result, a careful risk/benefit assessment is required in every instance.

It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness, and family conflict for those suffering from the disorder. A decrease in medication could affect the ability to safely drive and complete work-related tasks, which are vital aspects of normal life for people with ADHD.


She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy should educate family members, colleagues, and acquaintances about the condition, the effects on daily functioning, and the advantages of staying on the current treatment regimen. Educating medication for add in adults can also make the woman feel more comfortable in her struggle with her decision. It is also worth noting that certain medications are able to be absorbed through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be passed on to the baby.

Birth Defects and Risk of

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about the effects that the drugs could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers utilized two massive data sets to examine over 4.3 million pregnancy and determine whether stimulant medications increased birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication use was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The researchers of the study could not find any association between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are in the same vein as previous studies that showed the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of the time of pregnancy. The risk grew during the latter part 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 need a caesarean or have a low Apgar after delivery and have a baby that needed breathing assistance when they were born. The authors of the study were not able to eliminate selection bias because they limited the study to women with no other medical conditions that might have contributed to the findings.

Researchers hope their research will help doctors when they meet pregnant women. They suggest that although the discussion of risks and benefits is important however, the decision to stop or continue treatment should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, although stopping the medication is an option to look into, it is not recommended due to the high rate depression and other mental problems among 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 a difficult time adapting to life without them after the baby's arrival.

Nursing

It can be a challenge to become a mother. Women with ADHD who must work through their symptoms while attending physician appointments and getting ready for the arrival of a child and adapting to new routines in the home are often faced with a number of difficulties. Many women decide to continue taking their ADHD medication during pregnancy.

The majority of stimulant medications are absorbed by breast milk in small amounts, therefore the risk to breastfeeding infant is minimal. The rate of exposure to medication will vary based on the dosage and frequency of administration as well as the time of the day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not well understood.

Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the absence of research. This is a difficult decision for the woman, who must weigh the advantages of taking her medication as well as the risks to the foetus. Until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether 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 in a safe manner while breastfeeding and during pregnancy. In the end, more and more patients are choosing to do so and, in consultation with their doctor they have discovered that the benefits of continuing their current medication far outweigh any risks.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs and psychiatry. Pregnancy counselling should include discussion of a management plan for both the mother as well as the child, and monitoring for signs of deterioration, and the need for adjustments to the medication regimen.

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