Notes

Why You Should Focus On Making Improvements To ADHD Medication Pregnancy
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. There aren't many studies regarding how exposure over time may affect a pregnant fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that further 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. Doctors don't have the necessary data to provide clear recommendations but they can provide information regarding the risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who took stimulants during early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was correct and to reduce any bias.

medication for adult adhd conducted by the researchers was not without its limitations. The most important issue was that they were unable to separate the effects of the medication from those of the disorder that is underlying. This makes it difficult for researchers to determine whether the few associations observed between the groups exposed were due to the use of medications, or if they were confounded by comorbidities. In addition the researchers did not look at the long-term effects of offspring on their parents.

The study showed that infants whose mother took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy, or had stopped taking their medication before or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk for admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.

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

The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit for both mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this and, if possible, help them develop coping skills that can lessen the impact of her disorder in her daily life and relationships.

Medication Interactions

Many doctors are confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are usually made without clear and reliable evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors and the research on the topic.

The issue of possible risks to infants is difficult to determine. The research that has been conducted on this topic is based on observation rather than controlled studies, and the results are contradictory. Most studies limit their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study presented in the journal club addresses these limitations by analyzing data on live and deceased births.

The conclusion is that while some studies have shown that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no such relationship, and most studies demonstrate a neutral or slightly negative effect. Therefore, a careful risk/benefit assessment is required in every instance.

It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of isolation. In addition, a decrease in medication may affect the ability to do work-related tasks and safely drive that are crucial aspects of daily life for many people suffering from ADHD.

She suggests that women who are unsure about whether to continue or discontinue medication due to their pregnancy should consider educating family members, friends, and coworkers on the condition, its impact on daily functioning, and the benefits of keeping the current treatment plan. It can also help a woman feel supported in her decision. It is also worth noting that certain medications can be absorbed through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be transferred to the child.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases, so does concern about the potential adverse effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Using two massive data sets researchers were able to analyze more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increased risk of specific heart defects, like ventriculo-septal defects (VSD).

The researchers of the study could not discover any link between early use of medication and congenital anomalies like facial deformities, or club feet. The results are in line with previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the birth of their child. The risk increased in the latter stages of pregnancy, when a lot of women decided to stop taking their medication.

Women who used ADHD medications in the first trimester of pregnancy were also more likely to experience caesarean sections, a low Apgar score after delivery and a baby who needed breathing assistance during birth. The researchers of the study were not able to eliminate selection bias because they limited the study to women with no other medical conditions that could have contributed to the findings.

The researchers hope their research will aid in the clinical decisions of doctors who encounter pregnant women. They recommend that, while the discussion of risks and benefits is important however, the decision to stop or keep treatment should be based on the woman's needs and the severity of her ADHD symptoms.

The authors also warn that, while stopping the medication is an alternative, it is not an option to consider due to the high prevalence of depression and other mental health problems among women who are pregnant or postpartum. Further, the research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them following the baby's arrival.

Nursing

It can be overwhelming to become a mother. Women with ADHD who must work through their symptoms while attending physician appointments as well as getting ready for the arrival of their child and getting used to new routines at home can experience severe challenges. Many women choose to continue taking their ADHD medication during pregnancy.

The risk to a breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk at a low level. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and time of day. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not yet fully understood.

Because of the lack of evidence, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. It is a difficult decision for the woman who must weigh the advantages of continuing her medication against the risks to the foetus. Until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time.

Numerous studies have proven that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. In response, a growing number of patients are opting to do this. They have concluded through consultation with their doctor that the benefits of continuing their current medication outweigh any potential risks.

Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant people with ADHD understand their symptoms and underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration, and, if needed modifications to the medication regimen.

My Website: https://www.iampsychiatry.uk/adult-adhd-medication/