edgelynx19

ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies on how long-term exposure may affect a 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 the need for more high-quality research. Risk/Benefit Analysis Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the possible dangers for the fetus. Doctors don't have enough data to make unambiguous recommendations, but can provide information on risks and benefits to aid pregnant women in making informed choices. A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at higher risk of fetal malformations, or structural birth defects. The researchers used a large population-based study of case-control to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was accurate and to minimize any bias. However, the study had its limitations. The researchers were unable, in the first place, to separate the effects of the medication from the disorder. This limitation makes it difficult to determine whether the small associations observed in the exposed groups are due to medication use or the confounding effect of comorbidities. Additionally the study did not look at the long-term effects of offspring on their parents. The study did reveal that babies whose mothers had taken ADHD medications during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had stopped their medications before or during pregnancy. This increase was due to central nervous system disorders, and the increased risk of admission was not found to be influenced by which stimulant medications were taken during pregnancy. Women who took stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These increases did 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 benefit to both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this and, if possible, help them develop coping strategies that may reduce the effects of her disorder on her daily life and relationships. Interactions with Medication Doctors are increasingly faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made without solid and reliable evidence regardless, so doctors must weigh their knowledge from their own experiences, those of other doctors, and what research says on the topic, along with their own best judgment for each patient. The issue of possible risks to the infant can be particularly tricky. The research on this subject is based on observations instead of controlled studies and many of the findings are conflicting. In addition, most studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by looking at data from both 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, others have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative effect. In every case, a careful analysis of the risks and benefits should be conducted. For many women with ADHD and ADD, the decision to stop medication is difficult if not impossible. In a recent article published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. In addition, a decrease in medication can affect the ability to perform jobs and drive safely that are crucial aspects of daily life for a lot of people with ADHD. She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy educate family members, colleagues, and their friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment regimen. Educating them can also aid in ensuring that the woman feels supported when she is struggling with her decision. It is also worth noting that certain medications can pass through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug could be passed on to the baby. Risk of Birth Defects As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. With two massive data sets, researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect. The researchers of the study could not discover any link between early medication usage and other congenital anomalies, like facial deformities or club feet. The results are consistent with previous studies showing an increase, but not significant, in the risk of cardiac malformations among women who started taking ADHD medications prior to pregnancy. The risk was higher in the latter half of pregnancy, when many women are forced to stop taking their ADHD medications. Women who took ADHD medication in the first trimester were more likely to require a caesarean delivery and also have a low Apgar after delivery and have a baby that needed help breathing at birth. However, the authors 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 serve to inform the clinical decisions of doctors who encounter pregnant women. They suggest that although discussing the benefits and risks is important but 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 caution that while discontinuing the medications is an option, it is not an option that is recommended due to the high rate of depression and other mental health problems among women who are pregnant or post-partum. Further, medication for adult add shows that women who stop taking their medication will have a difficult transitioning to life without them after the baby is born. Nursing The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. Therefore, many women choose to continue taking their ADHD medication throughout the pregnancy. The risk to nursing infant is low because the majority of stimulant medication is absorbed through breast milk in low amounts. The rate of medication exposure will vary based on the dosage and frequency of administration as well as time of day. In addition, 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 yet fully known. Due to the absence of research, some doctors may be inclined to discontinue stimulant drugs during a woman's pregnancy. This is a difficult choice for the patient, who must balance the benefits of continuing her medication with the potential risks to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they plan or are taking to take medication during the perinatal time. Numerous studies have proven that women can continue to take their ADHD medication safely during pregnancy and while breast-feeding. As a result, more and more patients are choosing to do so and in consultation with their physician, they have found that the benefits of continuing their current medication outweigh any risks. It is essential for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should involve an approach that is multidisciplinary, including 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.