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ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these medications can affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders such as impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the advantages of taking them against the potential risks to the foetus. The doctors don't have the information to provide clear recommendations however they can provide information on the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large population-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists looked over the cases to ensure accurate case classification and to minimize the chance of bias.
The study of the researchers was not without its limitations. The researchers were unable, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to medication use, or if they were caused by co-morbidities. In addition, the researchers did not look at the long-term outcomes of offspring.
The study revealed that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who did not use any medication during pregnancy or had stopped taking their medication before or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a baby with a low Apgar score (less than 7). These risks did not seem to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the risk of a small amount 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, when possible, assist them in developing strategies to improve their coping abilities that may minimize the negative impact of her condition on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and being treated with medication, the issue of whether to keep or stop treatment during pregnancy is one that doctors are having to confront. The majority of these decisions are made without any evidence that is clear and definitive either way, so physicians have to weigh their experience, the experiences of other doctors, and what research says on the topic and their own judgments for each patient.
The issue of possible risks to the infant can be difficult to determine. A lot of studies on this issue are based on observational data rather than controlled research and their conclusions are often contradictory. The majority of studies focus on live births, which can underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these limitations by examining data on both live and deceased births.
The conclusion: While certain studies have demonstrated an association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies show a neutral or even slightly negative effect. In each case, a careful analysis of the potential risks and benefits is required.
For women suffering from ADHD, the decision to discontinue medication can be difficult, if not impossible. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness and family conflict for these patients. A loss of medication may affect the ability to drive safely and to perform work-related tasks which are vital aspects of daily life for people with ADHD.
She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy educate family members, coworkers and friends about the condition, its impact on daily functioning and the benefits of continuing the current treatment. Educating them can also help the woman feel supported when she is struggling with her decision. It is also worth noting that certain drugs can pass through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be transferred to the child.
Birth Defects and Risk of
As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the potential adverse effects of the drugs on the fetuses. click the up coming website page published in the journal Molecular Psychiatry has added to the body knowledge on this subject. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. While the overall risk 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 ventriculo-septal defect (VSD).
The researchers of the study did not find any association between early medication usage and other congenital anomalies like facial deformities or club feet. The results are consistent with previous studies revealing a small but significant increase in the risk of heart malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. The risk was higher in the later part of pregnancy, when a lot of women are forced to stop taking their medication.
Women who used ADHD medications 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. The authors of the study could not remove bias in selection since they limited their study to women who did not have any other medical conditions that might have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of physicians who see pregnant women. The researchers advise that while discussing risks and benefits are important, the choice on whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also advise that even though stopping the medication is an option, it isn't an option that is recommended due to the high rate of depression and other mental health issues among women who are pregnant or postpartum. Further, research shows that women who stop taking their medication will have a tough transitioning to life without them after the baby is born.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments and getting ready 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 medications are absorbed through breast milk in small quantities, so the risk to the 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, different medications enter the baby’s system via the gastrointestinal tract or through breast milk. The impact of these medications on the health of a newborn is not fully understood.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack 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 embryo. As long as more information is available, GPs can inquire about pregnant patients whether they have a history of ADHD or if they plan to take medication in the perinatal stage.
Numerous studies have proven that women can continue taking their ADHD medication in a safe manner while breastfeeding and during pregnancy. In the end, many patients are choosing to do so, and in consultation with their physician, they have discovered that the benefits of maintaining their current medication far outweigh any risks.
It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be informed about treatment options and build strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both the mother as well as the child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.
Website: https://postheaven.net/grapecopy3/15-of-the-most-popular-inattentive-adhd-medication-bloggers-you-should-follow
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