The Reason You Shouldn't Think About Improving Your ADHD Medication Pregnancy
The Reason You Shouldn't Think About Improving Your ADHD Medication Pregnancy
Blog Article
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 isn't much information on how long-term exposure to these medications could affect the fetus.
A study recently 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 higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication should consider the benefits of taking it against the potential risks to the foetus. Physicians don't have the data needed to make unequivocal recommendations, but they can provide information on benefits and risks that can assist pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large sample-based case control study to compare the incidence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure accurate classification of the cases and to reduce the chance of bias.
However, the study was not without its flaws. The researchers were unable, in the first place, to separate the effects caused by the medication from the disorder. This limitation makes it difficult to determine whether the small differences observed in the groups that were exposed are due to medication use or confounding by comorbidities. The researchers also did not examine long-term outcomes for the offspring.
The study revealed that infants whose mother had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy, or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the higher risk of admission was not found to be affected by the type of stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases didn't seem to be influenced by the kind of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefit to both the mother and child of continuing treatment for the woman's condition. Doctors should discuss with their patients about this and try to help them improve coping skills which can lessen the impact of her disorder in her daily life and relationships.
Interactions with Medication
As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether to continue or end treatment during pregnancy is a question that more and more doctors have to face. Most of the time, these decisions are taken in the absence of clear and authoritative evidence either way, so physicians have to weigh their experience from their own experiences, those of other doctors, and what research suggests on the subject, along with their own best judgment for each individual patient.
The issue of possible risks for infants can be particularly tricky. The research on this issue is based on observation instead of controlled studies and a lot of the results are in conflict. The majority of studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study presented in this journal club addresses these shortcomings by examining data on both live and deceased births.
The conclusion is that while certain studies have demonstrated an association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative impact. In all cases, a careful analysis of the risks and benefits must be performed.
For women suffering from ADHD, the decision to stop taking medication is difficult, if not impossible. In fact, in a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness and family conflict for patients with ADHD. A loss of medication may also affect the ability to safely drive and perform work-related tasks, which are crucial aspects of normal life for people with ADHD.
She suggests that women who aren't sure whether to continue taking the medication or stop it due to their pregnancy educate family members, colleagues, and friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment plan. It can also make the woman feel more comfortable in her struggle with her decision. Certain medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be transferred to the baby.
Birth Defects and Risk of
As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers utilized two massive datasets to analyze more than 4.3 million pregnancies and determine if the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medicines was associated with a slightly higher rate of specific heart defects, like ventriculo-septal defects (VSD).
The authors of the study didn't find any association between early use of medication and other congenital anomalies, like facial deformities, or club feet. The results are consistent with previous studies that have shown a small but significant increase in the risk of cardiac malformations among get more info women who began taking ADHD medications prior to pregnancy. This risk increased during the latter half of pregnancy when a large number of women stopped taking their medication.
Women who were taking ADHD medication during the first trimester were more likely to require a caesarean birth or have a low Apgar after birth and have a baby that needed help breathing after birth. However the researchers of the study were not able to eliminate selection bias by limiting the study to women who did not have any other medical conditions that could be a contributing factor to these findings.
Researchers hope their research will inform physicians when they meet pregnant women. The researchers advise that, while discussing risks and benefits are important, the choice about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her requirements.
The authors also caution that while discontinuing the medications is an option, it is not an option that is recommended due to the high incidence of depression and other mental health issues for women who are expecting or who are recently postpartum. Further, research shows that women who stop taking their medication will have a difficult time adjusting to a life without them after the baby is born.
Nursing
It can be overwhelming becoming a mother. Women with ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of a baby and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk in low amounts. However, the rate of medication exposure to the infant can differ based on dosage, how often it is administered and the time of the day the medication is administered. 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 completely understood.
Some doctors may stop taking stimulant medication during a woman's pregnancy due to the lack of research. It's a difficult choice for the woman who must weigh the benefits of taking her medication as well as the potential risks to the foetus. In the meantime, until more information is available, GPs may ask pregnant patients whether they have an background of ADHD or if they intend to take medication during the perinatal phase.
Many studies have shown that women can continue taking their ADHD medication safely during pregnancy and breast-feeding. In response, an increasing number of patients are choosing to do so. They have discovered, in consultation with their physicians that the benefits of keeping their current medication far outweigh any potential risks.
Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and reinforce strategies for coping. This should involve a multidisciplinary approach with the GP, obstetricians and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.