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The Little-Known Benefits Of ADHD Medication And Pregnancy
ADHD Medication and Pregnancy

Physicians are unable to provide accurate information on the safety of ADHD medications during pregnancy. As long as research is not available, doctors must weigh the benefits of using medication during pregnancy against the potential risks for offspring in each unique circumstance.

A recent population-based cohort study tracked 898 infants born to women who were taking ADHD medications throughout pregnancy (stimulants: methylphenidate, amphetamine, dexamphetamine; non-stimulants: modafinil, atomoxetine, clonidine) until they were diagnosed with a developmental disorder or died or left the country.

Risk/Benefit Discussion


CAP Smart Take:

Doctors are concerned with the long-term effects that drug exposure during pregnancy can have, especially for centrally stimulating medications like those used to treat ADHD. It is important that women receive appropriate advice from their doctors regarding the dangers and benefits of taking medication during pregnancy and prior to conception. In this CAP Smart Take, we examine the latest data in this area and how it can guide the practice of a physician.

Previous animal studies and illicit drug use research suggest that stimulant drugs are passed to the fetus through the placenta and may adversely affect the development of the fetus and growth. However, there is a lack of information on how the fetus responds to therapeutic doses of prescription stimulant medication during pregnancy and the majority of this data comes from single-arm studies that have not been sufficiently powered to detect possible significant correlations.

The most recent study by Cohen and co. stands out from the others as it is the largest and most carefully controlled. The study covered 364,012 pregnancies collected from the Danish Medical Registry. Information regarding medication use was collected by analyzing the redeemed medication. Researchers excluded women who had taken SSRIs or clonidine because these drugs can interfere with fetal NMDA and increase the risk of developing neurodevelopmental disorders, such as autism and ADHD. The authors re-analyzed their findings in order to account for the timing of exposure and to make sure that they control for confounding factors.

The data from this study, in addition to the results of other limited studies, suggest that the vast majority of women who continue to use their prescribed stimulant medications for ADHD throughout pregnancy don't experience adverse effects on their fetuses. Therefore, it is likely that a lot of pregnant women will continue to use their ADHD medication. It is essential for doctors to weigh the benefits and risks of these drugs prior to advising their pregnant patients to stop taking these medications. It is crucial that pregnant women with ADHD inform their parents family members, extended families, and employers of the decision they've made. This is because the symptoms of inattention, hyperactivity, and impulsivity will likely come back when the mother stops taking her medications.

click through the up coming document for women suffering from ADHD who wish to become pregnant should concentrate on a comprehensive plan of management that involves both pharmacologic and behavioral treatment and ongoing monitoring throughout the period of perinatal care. The plan should include a discussion about the current treatment regimens, specifically during the first trimester when the chances of harming the baby due to untreated ADHD are the highest. This should be a joint effort between obstetrics, psychiatry and primary care.

The risk/benefit discussion should also consider how a woman will plan to manage her symptoms of ADHD during pregnancy, including the effects on family functioning and what she might feel about discontinuing psychostimulant therapy during the initial stages of pregnancy. This should be based on an exhaustive review of the available evidence and consider the individual needs and concerns.

The authors of a large study that followed children who were exposed ADHD medications during utero concluded that "continuation psychostimulant use during the early stages of pregnancy was not associated with adverse birth outcomes, and if anything, it was associated with less stress among mothers." However their conclusion isn't without limitations. The study did consider other factors, such as the length of time that stimulant medication was used in addition to the dose and sociodemographics. There is no controlled research that examines the safety of a continued use of psychostimulants by nursing mothers.

There isn't any definitive evidence from a scientific study concerning the safety of ADHD medication during pregnancy. However, the majority of doctors are aware of what the literature suggests and will apply best practices when assessing the specific needs of each patient. It is known, for instance that babies born to mothers who take methylphenidate during the first trimester are more likely have cardiac malformations (Cooper, et al. 2018). However, this finding is based on a tiny study that didn't take into account the different the patient's demographics and underlying mental health conditions.

In a recent survey of ADDitude readers, they revealed that they are more likely than ever to stop taking their ADHD medication during the first trimester of pregnancy. However, women who stopped taking psychostimulants in the first trimester of pregnancy noticed an increase in depressive symptoms. They also felt less able to enjoy pregnancy and described family functioning as more difficult than those who remained on their dose of ADHD medication or increased it.

Work Functioning Test

The test for work function is a vital component of the exam since it determines if a patient can perform their job tasks. The test is designed for testing functional limitations. It includes graded material handling activities (lifting at different levels pulling and pushing), postureal tolerance exercises (sitting and standing as well as walking and balancing in a stoop, kneeling and stoop) as well as specialized tests. The examiner will analyse the results and formulate an appropriate return to work conclusion. ROC curves can be used to determine the point of minimal classification (MIC) in the general ability to work and physical work ability and the work-functioning issues score.

The MIC is calculated using the COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. This method differentiates scores for general physical work abilities and work-functioning issues, by answering an anchor question. This prevents a change in metrics from biasing the average.

Driving Test

The gold standard for treating ADHD is psychostimulant medication. It increases safety for drivers and decreases symptoms. Insufficiency due to severe, untreated ADHD can have profound psychosocial and financial consequences.

Psychotherapeutic treatments such as cognitive behavioral therapy (CBT) and "coaching" strategies have also been proven to reduce symptoms and enhance functioning. These strategies can help women tailor their schedules and utilize their coping abilities to minimize the impact of ADHD on their work and other aspects.

All of these factors could be important considerations in the decision whether to continue or end psychostimulant therapy. The most reliable data available show that, despite concerns about pregnancy outcomes when in utero stimulant medication is employed, the risks of this are minimal. Also, the results are complicated by other medication, the use of maternal healthcare as well as physical and mental health, and the comorbidities. Bang Madsen K., Bliddal m., Skoglund cb., Larsson h., Munk-Olsen t., Hove Thomsen p., Bergink V. In-utero exposure to attention deficit/hyperactivity disorder medication and its effects on offspring.

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